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The decontamination of a range of 'in-use' stainless steel surgical instruments by conventional hospital reprocessing techniques was studied, using scanning electron microscopic (SEM) and energy dispersive X-ray spectroscopic (EDX) analyses, with results obtained when an Ar:[O.sub.2] RF gas-plasma treatment step was added to the cleaning cycle. In some cases, protein contaminants were still retained on instruments subjected to conventional cleaning and sterilization after seven cleaning cycles. No retention of contamination was evident on the surfaces of instruments that were subjected to gas-plasma cleaning. The efficacy of the plasma decontamination is significantly improved by hydration of the tissue residues immediately before exposure to the plasma. The reasons for this are not known, but it is suggested that the production of excited OH radicals and H atoms within the tissue matrix may play some part. Deposition of fluorescently labeled protein from physiological saline solution shows that protein is incorporated into salt crystals formed on stainless steel surfaces. This protein is resistant to plasma etching, but it is shown that water treatment results in improved cleaning. A combination of effects including physical 'cracking' of the salt crystals under vacuum and dissolution of the inorganic matrix, which could possibly be accelerated by dipolar heating of the aqueous phase, may be responsible. Index Terms--Creutzfeldt-Jakob disease (CJD), decontamination, radio frequency (RF) gas-plasma, surgical instruments.

Dental handpieces (DHPs) become biofouled internally with patient derived material that is difficult to access for removal and inactivation. This study undertook a quantitative and qualitative investigation of protein contamination of internal components from three different types of DHP: the turbine, slow speed contra-angle and surgical. Eluates from the high speed turbine, low speed spray channels and surgical gear were assayed for protein using an orthophthaldehyde assay. Eluates concentrated by Amicon ultrafiltration were also analysed by SDS-PAGE, mass spectroscopy, Western blotting and ELISA. The surfaces of handpiece components were also investigated by SEM, EFSCAN and EDAX microscopy. Surgical gears contained highest levels of protein (403??g), followed by low speed spray channels (17.7??g) and the high speed turbine (<5??g). Mass spectroscopy of surgical gears demonstrated mostly serum derived proteins. Decontamination of the DHPs using an automated washer disinfector and handpiece irrigator showed a significant reduction in residual protein levels. [ABSTRACT FROM AUTHOR]

The decontamination of a range of "in-use" stainless steel surgical instruments by conventional hospital reprocessing techniques was studied, using scanning electron microscopic (SEM) and energy dispersive X-ray spectroscopic (EDX) analyses, with results obtained when an Ar: O2 RF gas-plasma treatment step was added to the cleaning cycle. In some cases, protein contaminants were still retained on instruments subjected to conventional cleaning and sterilization after seven cleaning cycles. No retention of contamination was evident on the surfaces of instruments that were subjected to gas-plasma cleaning. The efficacy of the plasma decontamination is significantly improved by hydration of the tissue residues immediately before exposure to the plasma. The reasons for this are not known, but it is suggested that the production of excited OH radicals and H atoms within the tissue matrix may play some part. Deposition of fluorescently labeled protein from physiological saline solution shows that protein is incorporated into salt crystals formed on stainless steel surfaces. This protein is resistant to plasma etching, but it is shown that water treatment results in improved cleaning. A combination of effects including physical "cracking" of the salt crystals under vacuum and dissolution of the inorganic matrix, which could possibly be accelerated by dipolar heating of the aqueous phase, may be responsible. [ABSTRACT FROM AUTHOR]