New HLD disinfectants, such as hydrogen peroxide-based HLDs, have emerged that offer some distinct benefits and thus merit review.

Our GUS Disinfection Soak Stations are compatible with any FDA-cleared HLD.

OPA is currently the most commonly used high-level disinfectant. OPA is an abbreviation for the chemical known as ortho-Phthalaldehyde (you can see why it's abbreviated!) OPA is an aldehyde-based chemistry marketed under three brands: Cidex OPA, Metricide OPA, and Rapicide OPA.

Another well-known aldehyde-based disinfectant is glutaraldehyde. Note the common root word: 'aldehyde.' Twenty years ago, glutaraldehyde-based disinfectants were the most commonly used high-level disinfectant.

There are several glutaraldehyde brands such as CIDEX, Metricide, Rapicide, Wavicide, etc. As a result of concerns over exposure, engineering control requirements and the need for faster soaking times, glutaraldehyde has been replaced for the most part by OPA-based HLDs.

The Instructions for Use for both OPA and glutaraldehyde require multiple large volume rinses after soaking and both types of HLDs require ten air exchanges per hour. Depending on the brand, you can re-use these aldehyde-based disinfectants for up to 14 days or 28 days, provided that they pass the Minimum Recommended Concentration (MRC) test.

Newer Oxidative HLDs

Alternatives to aldehyde chemistries have emerged in the past few years. These oxidative chemistries are typically hydrogen peroxide or peracetic acid based. Most are two-part solutions used in dedicated automated reprocessors for endoscopes. Revital-Ox RESERT™ (RESERT) from STERIS is hydrogen peroxide based HLD that is ready to use (no mixing).

As the advantages of oxidative chemicals become more apparent, facilities are looking more closely at the benefits of RESERT. RESERT has been an FDA-cleared high-level disinfectant since 2008. RESERT is hydrogen peroxide-based HLD, as opposed to aldehyde-based.

Hydrogen peroxide-based HLDs have recently been shown to be effective against the HPV virus, which has been a 'hot topic' as of late. While that is good news for oxidative chemistries, the FDA has not actually approved a testing method for efficacy against HPV for any high-level disinfectant in the USA. So, even though recent studies about high-level disinfectants' claim effectiveness against HPV, more validation per proper FDA testing protocols is required before any HLD can make this claim.

HPV is classified as a non-enveloped virus. Revital-Ox RESERT HLD has passed both the FDA and internationally recommended virus-inactivation test requirements to include demonstrated effectiveness against enveloped and non-enveloped viruses.

According to Inga Tchoumak, STERIS Product Manager of Revital-Ox^® RESERT®, "Oxidative chemistries are a safe alternative to aldehydes. There are no patient contraindications and they leave no toxic residues on devices; rather, they can remove potentially dangerous protein stains. Many are also considered environmentally friendly."

Revital-Ox RESERT does not require any special ventilation or extra engineering controls if you are reprocessing devices in a room that has a minimum of 6 air exchanges per hour (ACH). Typically, endoscopy reprocessing areas will have at least 6 ACH, as this is the recommended minimum number of ACH.

However, ultrasound areas, smaller rooms or rooms that have been converted to reprocessing areas may not meet the minimum requirement. If the general room ventilation is not sufficient or the customer is seeking extra assurance, then additional engineering controls should be implemented through use of a GUS Disinfection Soak Station.

If you're looking for a faster turnaround time, you don't have to automate to perform a quick HLD. Revital-Ox RESERT HLD has some significant advantages over OPA-based HLDs:

• 8 minute disinfection
• 1 low volume rinse vs. 2-3 large volume rinses. RESERT's single (and final) rinse can be done in a GUS rinse container, saving water which is especially important in areas susceptible to drought.
• Up to 21 day re-use

Remember:

All high-level disinfectants, including hydrogen peroxide, OPA and glutaraldehyde, are designed to kill microorganisms. CIVCO's ASTRA automated reprocessors and GUS Disinfection Soak Stations are both effective options to high-level disinfection of ultrasound probes. They contain splashes and spills, use less disinfectant and protect the delicate probes, patients and staff.

See the FDA-cleared high-level disinfectants available for use.