Technical Properties and Biological Safety of Reprocessing Technique for a Handpiece of Disposable Pulsatile Lavage Device: An Experimental Study
https://doi.org/10.5704/MOJ.2407.008
- Author:
Pongkunakorn A
1
;
Jutawiriyasakun M
1
Author Information
1. Department of Orthopaedic Surgery, Lampang Hospital, Lampang, Thailand
- Publication Type:Journal Article
- Keywords:
recycling, therapeutic irrigation, pulsatile flow, arthroplasty
- From:Malaysian Orthopaedic Journal
2024;18(No.2):55-62
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Bony surface cleaning using a pulse lavage
device (PLD) is essential for modern cementation of hip and
knee arthroplasties. This costly single-use device is a
medical waste and unaffordable for some patients.
Reprocessing is a worldwide standard strategy to solve this
problem. To determine the technical properties and
biological safety of a reprocessed PLD handpiece and
compare its performance under different power supplies.
Materials and methods: Eight brand-new disposable PLDs
were tested for baseline technical properties (flow rate, pulse
frequency, and peak pressure). Thereafter, they were
reprocessed and retested for 10 rounds using two different
power supplies. An adenosine triphosphate (ATP) swab test
was performed on the PLD accessory parts after cleansing
and disinfection. Passed-through isotonic sodium chloride
solution ejected from the reprocessed PLD underwent
aerobic bacterial culture. The unit costs of production were
analysed.
Results: The mean flow rate of the disposable PLD (1.5±0.1
L/min) was less than that of reprocessed PLD using DC15V
battery (2.5±0.3 L/min, p<0.001) and AC/DC15V3A adapter
(6.1±0.4 L/min, p<0.001). The mean pulse frequency and
peak pressure of the disposable PLD and reprocessed PLD
using DC15V battery were not different (18.5±0.8 vs
18.8±2.5 Hz, p=0.155 and 0.37±0.04 vs 0.38±0.03 N/mm2
,
p=0.640, respectively), but were lower than those using
AC/DC15V3A adapter (47.0±2.7 Hz, 0.45±0.03 N/mm2
,
p<0.001). All ATP swab tests, and aerobic fluid cultures
yielded negative results. The total cost of reprocessing was
10% of disposable PLD.
Conclusions: A disposable PLD handpiece can be
reprocessed without deteriorating its technical properties and
used with either retrieved DC15V battery or AC/DC15V3A
adapter for the power supply. As the biological safety of
reprocessed and disposable PLDs was comparable, it may be
clinically utilised with 90% cost reduction.
- Full text:202408211529244087916.2024my1373.pdf
