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Cleaning problems associated with diamond trephine drills in bone surgery.

Kämmerer PW, Heymann P, Palarie V, Neff A, Draenert FG - Ann Maxillofac Surg (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Oral-Maxillofacial and Plastic Surgery, University Medical Centre, Johannes Gutenberg-University Mainz, Germany ; Harvard Medical School, Boston, USA.

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Dear Sir, We would like to draw your attention regarding cleaning problems associated with diamond trephine drills in bone surgery... We used the Meisinger Diamond Trephine Control System (Meisinger, Neuss, Germany) to grind fresh porcine cancellous bone cylinders from the proximal tibia... In another study, rabbit bone was similarly harvested from the distal femur... Human bone cylinders were obtained from the pelvic rim in the related study using the forerunner model of Diamond TwInS System... This includes several communicable germs that cannot be simply ruled out by sterilization... It is known that infectivity of prions in bone material remains after sterilization resulting in the possible risk of several associated neurodegenerative diseases including scrapie and bovine spongiform encephalopathy (BSE)... Autoclaving does not guarantee a safe sterilization of bone grafts even though one would not expect that small bone residues are comparable to full size grafts examined elsewhere... Some manufacturers recommend specific cleaning instructions combining potassium hydroxide with ultrasound bath to remove the gluey bone residues on the diamond drills, as done by Karl Storz Inc. for their Diamond TwInS System... However, potassium hydroxide is a dangerous chemical with extreme risk of harm for skin and eyes that cannot be easily applied in a central hospital instrument sterilization facility... This special cleaning process requires a dedicated working place with all necessary safety measures... A validation of the Diamond TwInS System cleaning protocol by experts or the Federal office for disease control is recommended to prove the success of this method... Alternatively, diamond instruments for bone surgery could be used as disposables to ensure appropriate infection control conduct... We do follow this safe practice in clinical application.

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(a) Example for a diamond trephine after three cleaning cycles (Diamond Trephine Control, Hager and Meisinger Inc., Neuss, Germany) (microscope: Keyence VHX-2000), (b) Same trephine; red stars are marking the white bone matrix residues after cleaning (microscope: Zeiss Stemi-2000)
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Figure 2: (a) Example for a diamond trephine after three cleaning cycles (Diamond Trephine Control, Hager and Meisinger Inc., Neuss, Germany) (microscope: Keyence VHX-2000), (b) Same trephine; red stars are marking the white bone matrix residues after cleaning (microscope: Zeiss Stemi-2000)

Mentions: These results are from randomly observed and microscopically examined drills used in three studies conducted by our group.[567] The drills were cleaned as mentioned above. Figure 1a shows an example of a pre-cleaned drill, in Figure 1b the same drill after a single cleaning cycle is seen. Even after three cleaning procedures, bone residues within the diamond surface structure were observed [Figures 2a and b]. All examined drills showed similar residues.


Cleaning problems associated with diamond trephine drills in bone surgery.

Kämmerer PW, Heymann P, Palarie V, Neff A, Draenert FG - Ann Maxillofac Surg (2013)

(a) Example for a diamond trephine after three cleaning cycles (Diamond Trephine Control, Hager and Meisinger Inc., Neuss, Germany) (microscope: Keyence VHX-2000), (b) Same trephine; red stars are marking the white bone matrix residues after cleaning (microscope: Zeiss Stemi-2000)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814674&req=5

Figure 2: (a) Example for a diamond trephine after three cleaning cycles (Diamond Trephine Control, Hager and Meisinger Inc., Neuss, Germany) (microscope: Keyence VHX-2000), (b) Same trephine; red stars are marking the white bone matrix residues after cleaning (microscope: Zeiss Stemi-2000)
Mentions: These results are from randomly observed and microscopically examined drills used in three studies conducted by our group.[567] The drills were cleaned as mentioned above. Figure 1a shows an example of a pre-cleaned drill, in Figure 1b the same drill after a single cleaning cycle is seen. Even after three cleaning procedures, bone residues within the diamond surface structure were observed [Figures 2a and b]. All examined drills showed similar residues.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral-Maxillofacial and Plastic Surgery, University Medical Centre, Johannes Gutenberg-University Mainz, Germany ; Harvard Medical School, Boston, USA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Sir, We would like to draw your attention regarding cleaning problems associated with diamond trephine drills in bone surgery... We used the Meisinger Diamond Trephine Control System (Meisinger, Neuss, Germany) to grind fresh porcine cancellous bone cylinders from the proximal tibia... In another study, rabbit bone was similarly harvested from the distal femur... Human bone cylinders were obtained from the pelvic rim in the related study using the forerunner model of Diamond TwInS System... This includes several communicable germs that cannot be simply ruled out by sterilization... It is known that infectivity of prions in bone material remains after sterilization resulting in the possible risk of several associated neurodegenerative diseases including scrapie and bovine spongiform encephalopathy (BSE)... Autoclaving does not guarantee a safe sterilization of bone grafts even though one would not expect that small bone residues are comparable to full size grafts examined elsewhere... Some manufacturers recommend specific cleaning instructions combining potassium hydroxide with ultrasound bath to remove the gluey bone residues on the diamond drills, as done by Karl Storz Inc. for their Diamond TwInS System... However, potassium hydroxide is a dangerous chemical with extreme risk of harm for skin and eyes that cannot be easily applied in a central hospital instrument sterilization facility... This special cleaning process requires a dedicated working place with all necessary safety measures... A validation of the Diamond TwInS System cleaning protocol by experts or the Federal office for disease control is recommended to prove the success of this method... Alternatively, diamond instruments for bone surgery could be used as disposables to ensure appropriate infection control conduct... We do follow this safe practice in clinical application.

No MeSH data available.


Related in: MedlinePlus