CONF-9-Mireille-Ferlita.pdf

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1、REPROCESSING DENTAL HANDPIECES:A HOPE FOR ALL AND DENTAL PRACTICES?Name:Mireille Ferlita(C.S.S.D)Frdric Hamon(facilitiesmanag.team)Affiliation:CHU de NANTES(France)1SEMI CRITICAL DEVICES(1/2)Dental Surgery and Stomatology Infection Prevention Guide(France)(2006)Health Monitoring Institute(France):An

2、alysis of the infectiousrisk related to non-sterilization between each patient of rotaryinstrument holders in dental surgery(2009)Biofouling of surgical power tools during routine useA.Deshpande(UK),G.W.G.Smith,A.J.Smith;Journalof Hospital Infection(2015)Tooth,saliva,patients blood,water sprayBacter

3、ial,viral,particules and tissues contamination 2SEMI CRITICAL DEVICES(2/2)Predisinfection Cleaning/disinfection(A0=3000)+Sterilization Lubrication Health French Authorities(Sant public France)in 2019 Analysis of the infectious risk related to non-sterilization betweeneach patient of DHP in dental su

4、rgery(Sant Public France-2019)German Society of Hospital Hygiene,DGKH congress Berlin(2012)Recommandations by the quality task group-RKI/BArM(2012)Recommandations by Comident(a dental coordination committee)(2012)3What is the problem?Manufacturers instructions WD Market SafetyUsers needs Intricate D

5、evices No dimantlingISO 15883 complianceComplete reprocess in connexionTemperature(Sinner cercle)Detergent alcohol-based productLubricant Lubricant+water Fonctional Ergonomic4Yes we could make it better!How could we do?5PROJECT(2013-2018)Reject the use of water/oil emulsion Big load capacity Avoid t

6、he excessive handling of the operatorsOur philosophy:Reprocessing DHP safelyis not a matter of speed but of efficiency6PARTNERSHIP Thanks for the professionalism and complementarity Multiple skills,knowledge in mechanics,industrial automation and engineering 2 identical“DHP”WD called“LDL”2 Patents7S

7、PECIFICATIONS:A CONPLIANT REPROCESSWashing(internal and external)Rinsing(internal and external)Thermal disinfection(A03000)Drying-ISO 15883 Standards/A0:rotary devices must be in rotation motion when being cleaned-Comident(a dental coordination committee)(2012)-French Good Practices(Guidelines)-Manu

8、facturer instructionsLubrication(B)Lubrication(A)Lubrication(C)SterilizationThe 2 LDL 8SPECIFICATIONS:ADAPTERS Suitable connections:-MULTIflex couplings(turbine rotation)-INTRAmatic couplingsNo fluid stagnation within the DHPMultiflexIntramatic9SPECIFICATIONS:LUBRICATEAfter drying-Instrumentation Pr

9、ocessing(AKI Working Group Germany)(2012)-Manufacturer instructionsMultiflexIntramatic Quality of lubricant:-Specific high speed and dental-Biodegradable-Hydrolysis-resistant-Kinematic viscosity(DIN 51562-3)16 mm/s(40C)-Density=0,86 g/cm3(20 c)10QUALIFICATION:CLEANINGMethod:Soil test(Internal+extern

10、al surfaces)Protein Residue Test 1stOQ+OP:sampling of everything reOQ+OP:sampling of 5 DHP Every year compliance with ISO 15883 standard is ensured by a service provider11QUALIFICATION:DRYING AND LUBRICATION Traces of lubricant(water)Dental wash cart of 52 adapters 12FEEDBACK FROM 5 YEARS:USERSInter

11、nal team survey(2023)n=49 operators 300 DHP /day(2023)mini 180 to maxi 416Positive areasAreas for improvementBetter washed,dried and lubricated with this machine(69%)Difficulty to disconnect(66%)Start cycle and traceability (71%)Reprocess in 1 time(72%)Some DHP disconnect during the cycle(68%)Easy a

12、nd safe to connect(68%)Easy to lubricate(35%)Modularity(25%)Better access(37%)91%YES!13FEEDBACK FROM 5 YEARS:Technicalproblems Technical problems:-water leak-broken door hinge-adjustment of the lubricating dryer(due to excessive moisture)Failure rate:ratio number of service requests/number of cycles

13、 WD Downtime:-2022:0 to 101 days(WD instruments)vs?(LDL)Connexion DHP on LDL rack 14FEEDBACK FROM 5 YEARS:Patients safety DHP health :Total number 1600 DHP(2023)-June 2018 2021:No problems-Dec.2021-2022:increase in requests 2 Patients burns(surgery)Breakages of DHP No infections010020030040050060070

14、080090020162017201820192020202120222023DHP service requestsFor all servicesHospital Dental SchoolBeginning of LDLBrokenDHP Patientsburns15DISCUSSION Todaywashing,rinsing,drying and after lubricate is possible in one machine Not perfect but possible!To further improve:-Others Indicators-Comparatives

15、trials:with an independent laboratory with other DHP,3D printing technology DHP?.16DISCUSSION About other experiences:CSSD french survey(october 2023)n=64 french CSSD (28%respondents)Hospital DHP different origins Different reprocess 35%lubricant stain 44%additional handling 72%agree to improve WD market17CONCLUSIONCSSD Hospital,Clinic+Dental SchoolManufacturersScientific society.Dental Practices18Yes we make it better!19Please share your stories or your opinions20