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DECONTAMINATION


there is protein remaining on the instrument as bacteria can exist on, in, or under an area of protein, so to get at the bacteria, the protein has to be completely and consistently removed.


But herein lies the problem. As others have found out, protein is extremely difficult to remove and becomes more tenacious when heat is applied. This fact alone makes it incredibly difficult to consistently remove the protein fully in any thermal device. I’m not saying that it can’t be done, as others have shown (unpublished), but the inclusion of heat simply makes the task much more difficult. Obtaining ‘zero’ has always been the goal. It took some time to understand the issue fully and, of course, the potentially devastating consequences of failure. The real breakthrough came in 2014 when a ProReveal device was purchased. This investment enabled a ‘test and measure’ regime to be quickly established that yielded great progress.


Our research found that the removal of protein is easier in cold water with the


optimum temperature being between 17° to 20°C. By 2016, before the launch of the revised HTM0101, the point had reached whereby complete and consistent removal of protein had been achieved well into the ng range (as measured with a validated ProReveal device).


Then came the Health Technical Memorandum (HTM) that, among other things, stipulated that the ultrasonic activity should be validated on a very regular basis. This threw a spanner into the works as how could this be achieved? With a foil test? Surely not. As no technology existed at that time to measure ultrasonic cavitation, a sub-project was embarked on to develop a device that would accurately and consistently validate the ultrasonic activity in a tank of fluid. Two years later and in collaboration with a University, the world’s first device to measure electrical activity caused by cavitation and, as such, provide a measure of the cavitation itself, was developed. This piece of equipment opened several doors and enabled full compliance with the HTM.


The development of the Cavitation


Validation Device (CVD), coupled with a methodology of applying sound into fluid, delivered startling results and provided a major breakthrough in striving for ‘zero’ as not only were the levels of cleanliness achievable, but more importantly consistently delivered.


Natural dispersion


The natural dispersion of high frequency sound when applied into fluid is of a somewhat erratic nature – fine for cleaning jewelry or spectacles, but not for achieving the consistent precision cleaning that is required for healthcare. It is this natural dispersion of sound that is at the heart of the failure of successive manufacturers of surgical equipment cleaning systems to produce devices that consistently deliver what the sector needs.


The graphs 1 and 2, featured in this


article, give some indication of what is meant by ‘erratic dispersion’. Graph 1 shows the cavitation activity in a system that historically has been used to clean surgical


Graph 1


Graph 2 JANUARY 2021 WWW.CLINICALSERVICESJOURNAL.COM l 51





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