The place for disposable knives
http://eyeworld.org/article.php?sid=4523 [2008-7-29]
Tag : disposable clinical gloves
Disposable knives for ophthalmic surgery could be consideredattractive in terms of a potential reduced rate ofinfection—but this is a flawed concept, some surgeons believe
W ith less sterilization requirements related to disposableinstrumentation, surgeons might think there is less chance fortransmission of endotoxin or other potentially harmful agents tothe patient resulting from, say, autoclaving problems.Ophthalmologists also might believe that one-use disposable knivescould reduce the chance of transmission of the deadly sporadicCreutzfeldt-Jakob disease (CJD). While this second argument hassome merit, the likelihood of prion disease transmission remainsexceedingly small.
Mark Packer, M.D., clinical associate professor of ophthalmology,Casey Eye Institute, Oregon Health & Science University,Portland, suggested that reusable knives rather than disposableones are what cut down on infection risk.
“If you’re talking about bacterial endophthalmitis,which is our main concern, it’s the diamond knives that havethe advantage [of reducing infection risk] during clear cornealincision,” Dr. Packer said. “They cut incisions whichseal better.”
The diamond knife can cut an incision that seals immediately andstay sealed until the epithelium grows over and closes, he said.
Further, disease usually isn’t transmitted from human tohuman via reusable instrumentation. The greatest cause of ocularinfection resulting from surgery is staphylococcus bugs that liveamong the eyelashes, Dr. Packer said. It doesn’t matterwhether you use disposable or reusable instrumentation becausethose bugs can get access to the ocular surface either way withoutproper precautions, he said.
Disposable knives for ophthalmic surgery could be consideredattractive in terms of a potential reduced rate ofinfection—but this is a flawed concept, some surgeons believe
W ith less sterilization requirements related to disposableinstrumentation, surgeons might think there is less chance fortransmission of endotoxin or other potentially harmful agents tothe patient resulting from, say, autoclaving problems.Ophthalmologists also might believe that one-use disposable knivescould reduce the chance of transmission of the deadly sporadicCreutzfeldt-Jakob disease (CJD). While this second argument hassome merit, the likelihood of prion disease transmission remainsexceedingly small.
Mark Packer, M.D., clinical associate professor of ophthalmology,Casey Eye Institute, Oregon Health & Science University,Portland, suggested that reusable knives rather than disposableones are what cut down on infection risk.
“If you’re talking about bacterial endophthalmitis,which is our main concern, it’s the diamond knives that havethe advantage [of reducing infection risk] during clear cornealincision,” Dr. Packer said. “They cut incisions whichseal better.”
The diamond knife can cut an incision that seals immediately andstay sealed until the epithelium grows over and closes, he said.
Further, disease usually isn’t transmitted from human tohuman via reusable instrumentation. The greatest cause of ocularinfection resulting from surgery is staphylococcus bugs that liveamong the eyelashes, Dr. Packer said. It doesn’t matterwhether you use disposable or reusable instrumentation becausethose bugs can get access to the ocular surface either way withoutproper precautions, he said.
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