Properties of endotracheal tubes reprocessed by two procedures

Abstract

Background Reusing endotracheal tubes (EITs) has been performed in Indonesia with no evidence of its safety. Objective To evaluate sterility, as well as the mechanical, surface, and matrix properties of reused EITs following 2 different reprocessing procedures. Methods Reused EITs were cleaned and disinfected, then sterilized by ethylene oxide gas sterilization (group A) or dry heat sterilization (group B). New EITs were used as the standard for comparison. Microbes were identified and microbial counts were determined as colony forming units (CFUs). Evaluation of mechanical properties was perfonned by a Universal Testing machine. All samples underwent tensile and compression tests. Load defonnation curves were recorded from F max and strain at F max. Microstructure analysis was done using X􀁅ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). Results Positive cultures of commensal bacteria were found in 2/12 samples in group A, and 5/17 samples in group B. T here was no statistically significant difference between them (P =0.07). Pseudomonas aeruginosa or other common pathogens were not found. Samples from both groups showed equal flaccidity, compared to the standard. Surface microstructure analysis of reused EITs 'With XPS and EDX showed degradation of the matrix component. SEM analysis detected some large particles and fissures. EDX analysis on the large particles detected sodium and calcium signals. Altogether, signs of contamination and material damage were very strong. Conclusion Both reprocessing methods of reused EITs gave comparable results on sterility and mechanical behavior, but reprocessing may cause decreased surface and matrix quality.

Keywords

• endotracheal tube
• reprocessing
• reused
• microbiological evaluation
• mechanical properties
• microstructure analysis