title: Intermediate-level disinfection with accelerated hydrogen peroxide prevents accumulation of bacteria in Versajet™ tubing during repeated daily debridement using simulated-use testing with an inoculated pork hock.
abstract: OBJECTIVE
  This study assesses the feasibility of using the Versajet™ system (VJS) on an inoculated pork hock (PH) skin surface sequentially for 8 days with daily cleaning and intermediate-level disinfection (ILD).
  
  
  METHODS
  Daily, PHs were inoculated with bacteria suspended in artificial test soil (ATS). An ILD protocol with accelerated hydrogen peroxide (AHP, OxivirTB(®)) was employed to clean and disinfect the VJS between debridements.
  
  
  RESULTS
  PH skin contains 6.1-6.8×10(6)cfu/cm(2) bacteria. Bacterial counts in the handpiece and discharge hoses immediately after debridement of the PHs, and before cleaning, increased throughout the study period (5.19-6.43log10cfu/mL). Cleaning with the ILD protocol was reduced bacterial counts on the VJS by 6-log. Protein, a surrogate marker of organic contamination, was also reduced post-cleaning and ILD. Compared to a maximum post-debridement level of protein (57.9 μg/mL) obtained before ILD, VJS protein levels dropped to 9.8 (handpiece) and 13.8 μg/mL (discharge hose).
  
  
  CONCLUSIONS
  Disinfection of the handpiece and discharge hose after debridement with AHP resulted in a 6-log reduction in bacterial count and 4.2 fold reduction in protein. An ILD protocol with an AHP may be a feasible method for serial skin surface debridements with the VJS for up to eight days.
authors.affiliation: Sections of Plastic and General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Gawaziuk
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada; Microbiology Laboratory, St. Boniface Research Centre, Winnipeg, Manitoba, Canada.
authors.forename: M J
authors.initials: MJ
authors.lastname: Alfa
authors.affiliation: Microbiology Laboratory, St. Boniface Research Centre, Winnipeg, Manitoba, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Olson
authors.affiliation: Sections of Plastic and General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: Logsetty@cc.umanitoba.ca.
authors.forename: S
authors.initials: S
authors.lastname: Logsetty
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local; D002056:Burns / Q000601:surgery*; D002176:Candida albicans / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003646:Debridement / Q000379:methods*; D004203:Disinfection / Q000379:methods*; D013293:Enterococcus faecalis / Q000302:isolation & purification; D006861:Hydrogen Peroxide; D008953:Models, Anatomic; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013525:Surgical Instruments / Q000382:microbiology*; D013552:Swine
chemical_list: D000891:Anti-Infective Agents, Local; D006861:Hydrogen Peroxide
keywords: Accelerated hydrogen peroxide; Burns; Debridement; Reprocessing; Versajet