title: Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units.
abstract: BACKGROUND
  The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods.
  
  
  METHODS
  The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate.
  
  
  RESULTS
  Residual protein was detected on 72% (n = 136) of instruments reprocessed centrally and 90% (n = 170) of instruments reprocessed locally. Significantly less protein (p < 0.001) was recovered from instruments reprocessed centrally (median 20.62 μg, range 0 - 5705 μg) than local reprocessing (median 111.9 μg, range 0 - 6344 μg).
  
  
  CONCLUSIONS
  Overall, the results show the superiority of central reprocessing for complex podiatry instruments when protein contamination is considered, though no significant difference was found in residual protein between local decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency.
authors.affiliation: Institute of Infection, Immunity and Inflammation, Glasgow Dental School, College of Medicine, Veterinary and Life Sciences University of Glasgow, Glasgow, G2 3JZ, UK.
authors.forename: Gordon Wg
authors.initials: GW
authors.lastname: Smith
authors.affiliation: Central Decontamination Unit Cowlairs Industrial Estate 24 Finlas Street, Glasgow, G22 5DT, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Goldie
authors.affiliation: Podiatry Lead (North Acute) Department of Podiatry, Glasgow Royal Infirmary, Alexandra Parade, Glasgow G31 2ER, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Long
authors.affiliation: Institute of Infection, Immunity and Inflammation, Glasgow Dental School, College of Medicine, Veterinary and Life Sciences University of Glasgow, Glasgow, G2 3JZ, UK.
authors.forename: David F
authors.initials: DF
authors.lastname: Lappin
authors.affiliation: Institute of Infection, Immunity and Inflammation, Glasgow Dental School, College of Medicine, Veterinary and Life Sciences University of Glasgow, Glasgow, G2 3JZ, UK.
authors.forename: Gordon
authors.initials: G
authors.lastname: Ramage
authors.affiliation: Institute of Infection, Immunity and Inflammation, Glasgow Dental School, College of Medicine, Veterinary and Life Sciences University of Glasgow, Glasgow, G2 3JZ, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Smith