A piece of equipment that is used
for preventing and treating deformities and injuries of the musculoskeletal
system in man. Orthopedic devices include bandages, splints, prostheses, and
special apparatus. Several types of orthopedic devices are distinguished. A
fixing device is designed to either completely or partially restrict movements
in a joint; examples are hinged splints, which preserve a certain range of
movement in a joint, and rigid splints. Relieving devices are used to relieve
pressure on an ailing part by transferring support to healthy parts of an
extremity; examples include the Thomas splint and the Voskoboinikova apparatus.
Corrective devices are used to gradually correct a deformity; these include
corsets, splints, orthopedic footwear, and insoles and other devices to correct
abnormal positions of the foot. Compression-distraction devices correct
acquired or congenital deformities of the extremities, for example, curvature,
shortening, and pseudarthrosis; they include the Gudushauri, Ilizarov, Sivash,
and Volkov-Oganesian apparatus.
Chisels, osteotomes, electric and
pneumatic saws, and ultrasonics are used to dissect bones in order to eliminate
deformities or to join bone fragments. Rods, pins, plates, and screws are used
in osteosynthesis. Joint defects are replaced by plastic and metal internal
prostheses.
Symmetry Medical has issued its
own instructions for cleaning reusable surgical instruments, including devices
that may contain one or more canted coil springs. According to “Recommended
Care, Cleaning, and Sterilization for Reusable Instruments, Instructions for
Use,” all Symmetry Medical instruments may be safely and effectively
reprocessed using the manual or combination manual/automated cleaning
instructions provided in the document “unless otherwise noted in instructions
accompanying a specific instrument.”3
The company’s instructions are
written in accordance with ISO 17664, “Sterilization of Medical Devices—Information
to Be Provided by the Manufacturer for the Processing of Resterilizable Medical
Devices.”4 This standard sets out the specific information that medical device
manufacturers must provide “on the processing of medical devices claimed to be
resterilizable, and medical devices intended to be sterilized by the
processor.” It defines the types of information required to ensure that a
medical device can be processed safely so that it will continue to meet its
performance specification.
Symmetry’s reprocessing
instructions have been validated as being able to prepare the company’s
reusable instruments for use. Its document provides specific warnings,
precautions, and processing limitations, along with thorough cleaning
instructions. While detailing those caveats is beyond the scope of this
article, it is imperative that users read and understand them prior to
implementing this cleaning process. All of the company’s protocols must be
verified before they are put into practice.
In this method, excess biologic
soil is removed from the instruments using a disposable wipe. Devices are then
placed in a container of distilled water or covered with damp towels. The
company notes that soaking devices in proteolytic enzyme solution facilitates
the cleaning process, especially in the case of instruments with such complex
features as lumens, mating surfaces, blind holes, and cannulae. Instruments
that cannot be soaked or maintained in a damp state should be cleaned within 30
minutes of use to prevent them from drying out before cleaning. This method
requires that multicomponent instruments be disassembled before cleaning.
Symmetry’s guide outlines both a
manual and a combination manual/automated cleaning process. The manual process
involves nine steps, while the combined process involves seven. The test
discussed here involved the use of the manual process.
First, the instruments were
completely submerged in a proteolytic enzyme solution prepared according to the
manufacturer’s instructions, following which they were shaken gently to remove
trapped bubbles. Instruments with hinges or moving parts were actuated to
ensure that all surfaces contacted the solution. Lumens, blind holes, and
cannulations were flushed with a syringe to remove bubbles and to ensure that complete
contact was made with the solution. Instruments were soaked for a minimum of 10
minutes. Then, the surfaces were scrubbed using a soft nylon-bristle brush
until all visible soil was removed.
Symmetry notes that particular
attention should be given to crevices, roughened surfaces, cutting features,
hinged joints, sharp edges, box locks, and areas with small components or
springs. The company recommends that personnel insert a narrow nylon bristle
brush or pipe cleaner into lumens, blind holes, or cannulae with a twisting
motion and that they push it in and out multiple times to remove soil.
Scrubbing devices below the surface of the enzyme solution minimizes the
potential of aerosolizing contaminated solution.
At this stage, the instruments
were removed from the enzyme solution, rinsed, and then actuated in tap water
for a minimum of one minute. The company recommends that personnel flush
lumens, holes, cannulae, and other difficult-to-access areas thoroughly and
aggressively. This step applies equally to canted coil springs.
The instruments were then
completely submerged in the cleaning solution—an ultrasonic bath containing
detergent and de-gas—and shaken gently to remove any trapped bubbles. The
lumens, blind holes, and cannulations were flushed with a syringe to remove
bubbles and ensure that the solution contacted all the instrument surfaces.
Sonic cleaning was performed for a minimum of 10 minutes.
The company recommends that
stainless-steel instruments be separated from other metal instruments during
the ultrasonic cleaning process to avoid electrolysis. The instructions also
note that hinged instruments should be fully opened and that wire-mesh baskets
or trays designed for ultrasonic cleaners should be used. Regular monitoring
using an ultrasonic activity detector, aluminum foil test, test object surgical
instrument, or SonoCheck is also recommended.
After the instruments were
removed from the ultrasonic bath, they were rinsed in purified water for a
minimum of one minute or until there was no sign of residue detergent or
biologic soil. The instructions specify that all moveable and hinged parts
should be actuated during the rinsing procedure and that lumens, holes,
cannulae, and other hard-to-reach areas such as canted coil springs should be
flushed thoroughly and aggressively.
Like the validated Bal Seal
method, the Symmetry method specifies that all devices be thoroughly inspected
for residual biologic soil or detergent. If contamination is still present, the
cleaning process should be repeated. Symmetry requires that its devices be
sterilized prior to use and provides specific sterilization instructions at the
end of the manual. So if you are looking for Orthopedic Equipments visit Allindiayellowpage.com to get detail
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