Scratches in Endoscope Channels
by Ashley Small
Scratches exist in channels for a variety of reasons. There are many sharp objects sent down the channels that can cause damage. In addition, reusable brushes that have not been properly assessed for damage can cause ridges in the plastic channels due to metal ends that may be exposed.
Recently we were asked about clinical evidence of the efficacy of the PULL THRU™ Cleaning Brush at removing soil from scratches and other points of minor damage in a scope channel. We do not have direct clinical evidence and have never seen evidence for this for bristle brushes. However, we have several indirect pieces of information that support the efficacy of the PULL THRU Cleaning Brush to remove soil from scratches.
The PULL THRU Cleaning Brush instructions indicate to brush channels until clean. You cannot disinfect a dirty endoscope, so it is vital the channels are cleaned properly prior to placing the endoscope into Automated Endoscope Reprocessing machine (AER). A single pass of the PULL THRU™ Cleaning Brush is generally sufficient to clean a channel. If there is soil present on the last two wipers to exit the channel, brush the channel again. The soil on the last two wipers indicates there may be a lot of soil in the channel and repeated brushing is necessary to clean the channel.
If there is soil on the last two wipers extra brushing with the PULL THRU™ Cleaning Brush products will remove more soil. If you are using a bristle brush, there is no way to know if the channel needs more brushing, unless a borescope is used. The bristles on a bristles brush may actually push soil into the areas of damage within the channel walls. Since the PULL THRU Cleaning Brush creates a seal in the channel, the wipers create a suction action that aids in removing soil from the channel. Evidence such as the Charlton studies show that a PULL THRU Cleaning Brush removes more soil than a bristle brush.
In our experience there should be no problem using the PULL THRU Cleaning Brush up to three times per channel However, it should only be used on one scope before it is disposed. It is important that the PULL THRU Cleaning Brush is used according to Instructions for Use and local guidelines.
In the video below, you can see how the PULL THRU Cleaning Brush aids in the removal of soil with the channel starting at 39 seconds.