Study to examine best methods of cleaning surgical instruments

A new study will examine the best methods for cleaning surgical instruments to reduce the risk of variant CJD infection, a rare and fatal disease that affects the brain.
The study funded by the Scottish Infection Research Network, will focus on instruments used in neurosurgery and test different methods for cleansing surgical instruments.
A recent report in the British Medical Journal (BMJ) found that approximately one in 2,000 people in UK carry Variant Creutzfeldt-Jakob disease (vCJD), a degenerative brain disease often called the human form of mad cow disease, without displaying any symptoms higher than previously thought.
There is no cure for vCJD and no test to screen for it in blood donations, so scientists are keen to ensure that surgical instruments used in operations do not present a risk for transmitting the disease which is caused by a prion- an infectious, misshapen protein.

With new data suggesting that one in 2,000 people potentially carrying vCJD prions, the risk of transmission of the disease via surgical instruments remains a public health concern, says Professor Andrew Smith of the University of Glasgow who is leading the study which also involve NHS Greater Glasgow and Clyde and Health Facilities Scotland.
Coupled with this, the resistance of prions to heat sterilisation means the cleaning stage is important to remove any potentially infectious tissue.

A major factor influencing cleanability for instruments is the ability to prevent drying of residual tissue onto the instruments.
There is some evidence to suggest that the longer you leave dried-on residues on instruments, the more difficult it is to remove.

This project aims to provide an evidence base for improved cleaning and risk reduction for neuro surgical instruments.
The scientists will investigate different processes, in-vitro and in-vivo, to improve the cleaning of instrument based on existing and novel protein-detection assays.
They will consider efficacy, cost-effectiveness and ability to integrate the cleaning techniques into existing operational processes for instrument decontamination.
The study will use standard and new protein visualisation techniques to improve surgical instrument quality control by measuring and locating any residual tissue left on surgical instruments.