Randomized Controlled Trial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2024; 30(31): 3680-3688
Published online Aug 21, 2024. doi: 10.3748/wjg.v30.i31.3680
Efficacy of spray flushing in the reprocessing of flexible endoscopes: A randomized controlled trial
Jiang Du, Miao Zhang, Si-Yuan Tao, Lian-Song Ye, Hui Gong, Bing Hu, Qiong-Ying Zhang, Fu Qiao
Jiang Du, Miao Zhang, Lian-Song Ye, Hui Gong, Bing Hu, Qiong-Ying Zhang, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jiang Du, Miao Zhang, Hui Gong, Qiong-Ying Zhang, West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
Si-Yuan Tao, Fu Qiao, Department of Infection Control, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Lian-Song Ye, Bing Hu, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Co-first authors: Jiang Du and Miao Zhang.
Co-corresponding authors: Qiong-Ying Zhang and Fu Qiao.
Author contributions: Du J and Zhang M designed this study, and collected and analyzed the data, and they made equal contribution to the manuscript; Tao SY, Gong H, and Hu B took part in this study as endoscopic operators or assistants; Ye LS, Zhang QY, and Qiao F drafted the manuscript and gave final approval of the version to be published; Zhang QY and Qiao F made equal contribution to the manuscript.
Supported by West China Nursing Discipline Development Special Fund Project, No. HXHL21029.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of West China Hospital of Sichuan University.
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry. The registration identification number is ChiCTR2300079006.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Dr. Zhang has a patent 202421340452.X pending to Chengdu Huayi Zhihe Intellectual Property Agency.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiong-Ying Zhang, BMed, Chief Nurse, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. hxnjzqy@163.com
Received: March 24, 2024
Revised: July 11, 2024
Accepted: August 1, 2024
Published online: August 21, 2024
Processing time: 141 Days and 22 Hours
Abstract
BACKGROUND

Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.

AIM

To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.

METHODS

This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group (n = 30) and an experimental group (n = 30). The material of Teflon tubes was the same as that of the endoscope working channel. Endoscopes in the control group were manually cleaned using traditional cleaning brushes, while those in the experimental group were cleaned using the newly developed spray flushing system. ATP levels, cleanliness, and microbiological testing of the working channels were measured. Additionally, Teflon tubes in the control group underwent 500 passes with a cleaning brush, while those in the experimental group were subjected to the spray flushing system, and channel damage was evaluated.

RESULTS

The ATP levels (RLU) in the two groups were 32.5 (13-66) and 26 (16-40), respectively (P > 0.05). Cleanliness scores were 1.5 (1-2) and 1 (1-2), respectively (P > 0.05). Debris was found in 73.3% of the control group, which was significantly higher than 46.7% in the experimental group (P < 0.05). Microbiological tests for both groups yielded negative results. Teflon tube damage in the control group was rated at 4 (4-5.25), which was significantly higher than in the experimental group 4 (3-4) (P < 0.01).

CONCLUSION

The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.

Keywords: Endoscope, ATP, Flexible endoscope, Disinfection, Reprocessing

Core Tip: Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels. Our team has developed a spray flushing brush to replace traditional bristle brushes in the cleaning process. Compared with traditional cleaning brushes, the spray flushing system in reprocessing of flexible endoscopes did not compromise the cleaning quality and microbial cultures. However, the spray flushing system demonstrated better debris removal from the working channels and reduced working channel damage.