Course Access
Hi Matthias,
This has come up often about the fact that swabsticks are not “sterile”.
I get asked about it alot.
The inability to heat treat for sterilisation with IPA is obviously a
combustable issue. 😉
However, the sterilisation process also has some destabilisation of the
CHG (from what I have heard only).
I am unawwre of ANY other product on the market at the moment that is
completely sterilised for use (that contains CHG and IPA)
If you are happy, would you mind forwarding me the correspondence with
SoluMed as I would like to also investigate this.
Regards,
Tim..
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition
Service
Conjoint Lecturer, University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
________________________________
Behalf Of Matthias Maiwald (KKH)
Dear Tim, dear Colleagues,
The use of 2% CHG with isopropanol versus 0.5 or 1% makes perfect
biological and microbiological sense, but there are currently no data
available from clinical trials (i.e. outcomes-based research) having
compared the higher versus the lower concentration.
I wonder about the Solu IV swabsticks that are being mentioned. Earlier,
in 2008, someone mentioned that they are not labelled as sterile. I
looked into this a little further and contacted the Canadian
headquarters, and they also stated that they are not sterile in a strict
sense. It became obvious that the person from the headquarters who I was
corresponding with had absolutely not the slightest clue about the
concepts of sterility.
It is well known that alcohol products need to be filtered in the
process of production, in order to exclude bacterial spores. This is a
well-established standard process, and most companies just simply do it.
A recent article in ICHE highlighted problems with alcohol pads where
this apparently had not been done:
http://www.ncbi.nlm.nih.gov/pubmed/22669227
For items like the single-use swabsticks (soeaked with alcohol) that are
packaged, I would assume (but I don’t know for certain) that the plastic
sticks would have to be irradiated for sterility separately in the
production process and the alcohol filtered (as stated above).
At the time, I ended up not following through with the correspondence
(somewhat frustrated by the Canadian response), but I wonder if anyone
from this list has looked at this issue (?).
Best regards, Matthias.
—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387
Behalf Of Tim Spencer
Robert,
We have done so and do so for EVERY IV device, not just PIVs.
2% CHG in 70% IPA – its all evidence based and there is plenty of
literature to support it as well.
We previously used 0.5% CHG in 70% IPA.
We use Solu-IV swabsticks (tinted for insertion and clear for
maintenance) and the large wipes.
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition
Service
Conjoint Lecturer, University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
________________________________
Behalf Of Robert Robinson
Good morning
I would like to know from those facilities who currently uses 70%
Isopropyl alcohol v/v in 0.5% to 1% Chlorhexidine, and are moving
towards or have now changed to using 2% Chlorhexidine in alcohol
specifically for insertion of an Peripheral IVC.
I am aware of the current recommendations surrounding this but would
like others comments on this matter.
regards
Robert Robinson
Clinical Nurse Consultant | Infection Control
Blacktown/Mt. Druitt Hospitals
Tel 02 9881 8994 | Mob 0408 923 789 |
robert.robinson@swahs.health.nsw.gov.au
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