Structural damage and chemical contaminants on reprocessed arthroscopic shaver blades.

摘要

BACKGROUND: In response to socioeconomic pressure to cut budgets in medicine, single-use surgical instruments are often reprocessed despite potential biological hazard. PURPOSE: To evaluate the quality and contaminants of reprocessed shaver blades. HYPOTHESIS: Reprocessed shaver blades have mechanical damage and chemical contamination. STUDY DESIGN: Controlled laboratory study. METHODS: Seven blades and 3 abraders were reprocessed 1 time or 3 times and then were assessed. In the first part of the study, structural damage on the blades after 3 reprocessings was compared to that after 1 reprocessing using optical microscopy. In the second part, surface damage was observed using optical microscopy and scanning electron microscopy; elemental and chemical analyses of contaminants found by the microscopy were performed using scanning electron microscopy/energy dispersive x-ray spectroscopy, scanning Auger microscopy, and Fourier transform infrared spectroscopy. RESULTS: Optical microscopic examination revealed abrasion on the surface of the inner blade and cracks on the inner tube after 1 reprocessing. These changes were more evident after 3 reprocessings. Scanning electron microscopy/energy dispersive x-ray spectroscopy of the inner cutter of the blade reprocessed once showed contaminants containing calcium, carbon, oxygen, and silicon, and Fourier transform infrared spectroscopy demonstrated biological protein consisting mainly of collagen, some type of salts, and polycarbonate used in plastic molding. Scanning electron microscopy/energy dispersive x-ray spectroscopy of the inner cutter of the reprocessed abrader revealed contaminants containing carbon, calcium, phosphorous, and oxygen, and Fourier transform infrared spectroscopy showed H2O, hydroxyapatite, and hydroxyl proteins. Scanning Auger microscopy showed that the tin-nickel plating on the moving blade and abrader was missing in some locations. CONCLUSION: This is the first study to evaluate both mechanical damage and chemical contaminants containing collagen, hydroxyapatite, and salts on the reprocessed arthroscopic shaver blades. CLINICAL RELEVANCE: Surgeons should keep in mind that mechanical damage and chemical contamination are found on reprocessed arthroscopic blades.