Study on Routine Inspection Method for Flexible Intramedullary Reamer and Its Impact on Reducing Risk of Surgical Site Infection

Wenru Huang; Xin Ju; Yunyu Jin; Pengjiao Niu

doi:10.11910/j.issn.2791-2043.2025.2.07

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Study on Routine Inspection Method for Flexible Intramedullary Reamer and Its Impact on Reducing Risk of Surgical Site Infection

MONOGRAPHIC STUDY | Updated：2026-02-06

- Study on Routine Inspection Method for Flexible Intramedullary Reamer and Its Impact on Reducing Risk of Surgical Site Infection
- Sterile Supply Vol. 4, Issue 2, (2025)
- Affiliations：
  
  1.Central Sterile Supply Department, The First Bethune Hospital of Jilin University, Changchun, Jilin, 130033, China
  2.Central Sterile Supply Department, The First People’s Hospital of Jinzhong , Jinzhong Shanxi, 030600, China
- Author bio：
  
  Wenru Huang
  Yunyu Jin at 280824903@qq.com
  Pengjiao Niu at npj258@163.com
- Funds：
- DOI：10.11910/j.issn.2791-2043.2025.2.07
  CLC：
- Published：15 August 2025
- Accepted：
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Huang Wenru,Ju Xin,Jin Yunyu,et al.Study on Routine Inspection Method for Flexible Intramedullary Reamer and Its Impact on Reducing Risk of Surgical Site Infection[J].Sterile Supply,2025,04(02):106-116.
DOI：

Huang Wenru,Ju Xin,Jin Yunyu,et al.Study on Routine Inspection Method for Flexible Intramedullary Reamer and Its Impact on Reducing Risk of Surgical Site Infection[J].Sterile Supply,2025,04(02):106-116. DOI： 10.11910/j.issn.2791-2043.2025.2.07.

摘要

Abstract

Objective

To explore the inspection methods for flexible intramedullary reamers (FIRs) to ensure cleaning quality and evaluate their potential value in reducing the risk of surgical site infection (SSI) in patients.

Methods

FIRs are categorized into “wave-type” and “thread-type” based on structural characteristics. FIRs used consecutively within the same medical institution were designated as Group A

while those used non-consecutively (by circulating across institutions) were as Group B. During the trial period

FIRs from both groups were cleaned according to a unified standard procedure. The turnover frequency and cleaning effectiveness of the two FIR types within the same institution were recorded for both groups. Cleaning quality was assessed using adenosinetriphosphate (ATP) bioluminescence assay and two types of visual inspection devices.

Results

Overall

the qualification rates for FIR surfaces and lumens via visual inspection were lower than those from the ATP bioluminescence assay for the corresponding areas (

0.001). Comparative results from visual inspection devices showed that the cleaning qualification rate for wave-type FIRs was si

gnificantly higher than for thread-type FIRs (89.03% VS 73.39%

=11.14

0.001); the cleaning qualification rate for Group A FIRs was significantly higher than for Group B (89.86% VS 73.28%

=12.39

0.001). Multivariate logistic regression analysis indicated that

after adjusting for cumulative usage count

instrument type (thread-type VS wave-type

odds ratios (OR) =3.21

95% confidence interval (CI): 1.67~6.18

0.001) and usage mode (Group B VS Group A

OR=3.58

95% CI: 1.84~6.97

0.001) remained independent risk factors for cleaning failure.

Conclusion

For lumens with complex structures

such as FIRs

only tested by ATP is insufficient to fully demonstrate cleanliness; visual inspection devices is recommended to introduce as a supplement. In addition

it is advised to establish and implement standardized cleaning procedures to ensure consistency and effectiveness of cleaning operations across different medical institutions. Furthermore

where conditions permit

wave-type FIRs may help achieve more reliable cleaning results

thus serving as one component of comprehensive measures to reduce the risk of surgical infection.

关键词

Keywords

references

WANG J , LI H M , JIA H B , et al . Intramedullary versus extramedullary fixation in the treatment of subtrochanteric femur fractures: a comprehensive systematic review and meta-analysis [J ] . Acta Orthop Traumatol Turc , 2020 , 54 ( 6 ): 639 - 646 .

PESANTE B D , STACEY S C , KIM Y J , et al . Single-use reamer shafts for intramedullary nail fixation: an addressable source of extraneous cost and medical waste in orthopaedic surgery [J ] . J Orthop Trauma , 2023 , 37 ( 12 ): 640 - 643 .

ZHENG S W , JIANG D , LIU P , et al . Management quality of surgical instrument and influence of cleaning and sterilization on the surgical outcomes of the patient: a review [J ] . Altern Ther Health Med , 2023 , 29 ( 8 ): 863 - 869 .

ANAZOR F , SIBANDA V , ALTAF K , et al . The impact of sterile instrument set wrapping defects on trauma and orthopaedic surgery theatre lists [J ] . Cureus , 2022 , 14 ( 10 ): e29861 .

SCHÖMIG F , PERKA C , PUMBERGER M , et al . Implant contamination as a cause of surgical site infection in spinal surgery: are single-use implants a reasonable solution?- a systematic review [J ] . BMC Musculoskelet Disord , 2020 , 21 ( 1 ): 634 .

OUIRUNGROJ T , APICHAI S , PATTANANANDECHA T , et al . Smart-detection approach for protein residues to evaluate the cleaning efficacy of reusable medical devices [J ] . J Hosp Infect , 2024 , 145 : 44 - 51 .

LINK T . Guidelines in practice: instrument cleaning [J ] . AORN J , 2021 , 114 ( 3 ): 241 - 251 .

HUANG J L , YI L Y , CHEN Y H , et al . Factors associated with cleaning quality of reusable medical devices at a single center in China [J ] . Heliyon , 2024 , 10 ( 2 ): e24194 .

MASIA M D , DETTORI M , DERIU G M , et al . ATP bioluminescence for assessing the efficacy of the manual cleaning procedure during the reprocessing of reusable surgical instruments [J ] . Healthcare (Basel) , 2021 , 9 ( 3 ): 352 .

SANNA T , DALLOLIO L , RAGGI A , et al . ATP bioluminescence assay for evaluating cleaning practices in operating theatres: applicability and limitations [J ] . BMC Infect Dis , 2018 , 18 ( 1 ): 583 .

SANTOS R K D , POZZER C E , RABAIOLI C M , et al . Central sterile services department: screening of automated cleaning in liposuction cannulae [J ] . Rev Gaucha Enferm , 2022 , 43 : e20210057 .

LOPES L O , COSTA D M , TIPPLE A V , et al . Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation [J ] . J Hosp Infect , 2019 , 103 ( 1 ): e53 - e60 .

COSTA D M , LOPES L K O , VICKERY K , et al . Reprocessing safety issues associated with complex-design orthopaedic loaned surgical instruments and implants [J ] . Injury , 2018 , 49 ( 11 ): 2005 - 2012 .

ZHANG Y Q , LIU B , TONG Z Y . Adenosine triphosphate (ATP) bioluminescence-based strategies for monitoring atmospheric bioaerosols [J ] . J Air Waste Manag Assoc , 2022 , 72 ( 12 ): 1327 - 1340 .

LIU S T , ZHAO J B , GUO Y L , et al . Application of ATP-based bioluminescence technology in bacterial detection: a review [J ] . Analyst , 2023 , 148 ( 15 ): 3452 - 3459 .

RODRIGUEZ J A , HOOPER G . Adenosine triphosphate-bioluminescence technology as an adjunct tool to validate cleanliness of surgical instruments [J ] . AORN J , 2019 , 110 ( 6 ): 596 - 604 .

LI Y , LU Y , CAI R , et al . Monitoring the cleanliness of reusable surgical instruments in central sterile supply department by adenosine triphosphate method [J ] . J AOAC Int , 2022 , 105 ( 3 ): 844 - 847 .

SMITH A , WINTER S , LAPPIN D , et al . Reducing the risk of iatrogenic Creutzfeldt-Jakob disease by improving the cleaning of neurosurgical instruments [J ] . J Hosp Infect , 2018 , 100 ( 3 ): e70 - e76 .

YANG L Y , XUN Q , XU J , et al . Application of the defect management improvement mode under Joint Commission International standard to improve the instrument cleaning and disinfection effect and management quality in the central sterile supply department: a randomized trial [J ] . Ann Transl Med , 2022 , 10 ( 3 ): 137 .

ASSADIAN O , HARBARTH S , VOS M , et al . Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review [J ] . J Hosp Infect , 2021 , 113 : 104 - 114 .

OFSTEAD C L , HOPKINS K M . Sterilization central: the value of borescopes in detecting damage, soil, fluid, and foreign objects in flexible endoscopes [J ] . Biomed Instrum Technol , 2020 , 54 ( 2 ): 146 - 152 .

OFSTEAD C L , SMART A G , HOPKINS K M , et al . The utility of lighted magnification and borescopes for visual inspection of flexible endoscopes [J ] . Am J Infect Control , 2023 , 51 ( 1 ): 2 - 10 .

VEIGA-MALTA I . Preventing healthcare-associated infections by monitoring the cleanliness of medical devices and other critical points in a sterilization service [J ] . Biomed Instrum Technol , 2016 , 50 ( Suppl 3 ): 45 - 52 .

HERVÉ R C , HEDGES J , KEEVIL C W . Improved surveillance of surgical instruments reprocessing following the variant Creutzfeldt-Jakob disease crisis in England: findings from a three-year survey [J ] . J Hosp Infect , 2021 , 110 : 15 - 25 .

CHEN A Q , ZOU X M , TAN Y H , et al . Multicenter comparative study of three “non-destructive” methods of detecting the cleanliness of the da Vinci surgical robotic instrument [J ] . Gland Surg , 2021 , 10 ( 12 ): 3305 - 3313 .

BRONZATTI J G , DE SOUZA R Q , NIERO C V , et al . Evaluation of cleaning and sterilization of liposuction cannulas after intentional contamination with human fat, Mycobacterium abscessus subspecies bolletii, and Geobacillusstearothermophilus [J ] . J Hosp Infect , 2023 , 136 : 8 - 13 .

RUTALA W A , WEBER D J . Risk of disease transmission to patients from “contaminated” surgical instruments and immediate use steam sterilization [J ] . Am J Infect Contr , 2023 , 51 ( 11 ): A72 - A81 .

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