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Comparison of Sterilization of Reusable Endoscopic Biopsy Forceps by Autoclaving and Ethylene Oxide Gas

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Abstract

Background and Aims

Every country has standardized reprocessing guidelines for reducing the risk of microorganism transmission via reusable biopsy forceps. Sterilization is performed either by autoclaving or with the use of ethylene oxide (EO) gas. However, there are no clear standard global recommendations. The aim of this study was to determine whether EO gas or autoclaving is a safer and more effective method for the sterilization of reusable forceps.

Methods

This was a prospective study conducted at multiple tertiary referral centers. Seventy reusable biopsy forceps that had been reused at least 20 times each were collected from six endoscopy centers. In all, 61 forceps from five centers were sterilized using EO gas, and the nine forceps from the remaining center were placed in an autoclave. We performed real-time polymerase chain reaction (RT-PCR) for Mycobacterium tuberculosis and hepatitis B virus and performed bacterial cultures on the reusable forceps, which were cut into 2- to 3-cm sections. The forceps were also scanned with an electron microscope (EM) to detect surface damage and contamination.

Results

Escherichia coli bacteria were cultured from 2 of the 61 (3.3%) reusable biopsy forceps sterilized with EO gas. On EM scanning, abundant debris and tissue materials remained on the cup surfaces of the reused biopsy forceps and on their inner wires. No microorganisms were found on the autoclaved forceps.

Conclusions

Sterilization with EO gas may be inadequate because the complicated structure of the forceps may interfere with sterilization. Therefore, for optimum safety, reusable biopsy forceps should be sterilized by autoclaving.

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Authors and Affiliations

  1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea

    Jai Hoon Yoon, Byung Chul Yoon & Hang Lak Lee

  2. Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea

    Jun Kyu Lee

  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Yong-Tae Kim & Dong Ho Lee

  4. Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea

    Il Ju Choi

  5. Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea

    Don Haeng Lee

  6. Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, Korea

    Dong Hee Kim

  7. Department of Gastroenterology, Hanyang University College of Medicine, Seoul, Korea

    Byung Chul Yoon

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  1. Jai Hoon Yoon
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Correspondence to Byung Chul Yoon.

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Yoon, J.H., Yoon, B.C., Lee, H.L. et al. Comparison of Sterilization of Reusable Endoscopic Biopsy Forceps by Autoclaving and Ethylene Oxide Gas. Dig Dis Sci 57, 405–412 (2012). https://doi.org/10.1007/s10620-011-1884-7

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  • DOI: https://doi.org/10.1007/s10620-011-1884-7

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