The PULL THRU™ Cleaning Brush approach to cleaning instrument channels has been tested to confirm its superior performance when compared with bristle brushes.  A link to each study summarised here is available to the right. 

University Hospitals Birmingham Study 2012

The Birmingham study assessed the performance of the PULL THRU™ after one pass through a pre contaminated channel against a bristle brush after five passes through the channel using a Ninhydrin test to measure detectable protein and a visual inspection was made to detect soil.

The results indicate that a single pass of the PULL THRU™ is as effective as five passes of the bristle brush tested against.
Deventer Study 2011

The Deventer study compared the amount of protein removal in the channel of a range of colonoscopies after brushing with a reusable bristle brush, a single use bristle brush and a PULL THRU™. The device was passed down the channel of the colonoscope once when the scope was manually cleaned.

The protein loading in the channels was measured prior and subsequent to cleaning. The study found that the PULL THRU™ removed 18% more atp (organic material) than brushing with a single use brush and 30% more material than reusable brushes.

Charlton Study, Australian Infection Control 2007

The Charlton study measured the weight of pre-loaded soil removed after a single pass of PULL THRU™ versus six passes of various bristle brushes. The PULL THRU™ outperformed the other products every time.

Other studies

There are a number of other studies referring to the benefits of the PULL THRU™ Cleaning Brush approach to manual cleaning of channels. 

Alfa, Michelle & M. Ribeiro, Maira & da Costa Luciano, Cristiana & França, Rodrigo & Olson, Nancy & Degagne, Pat & Singh, Harminder. (2017). Gastrointestinal Endoscopy. 86. 10.1016/j.gie.2017.05.014.

In this study, the Authors reprocessed endoscopes each day for five days, storing them wet overnight to facilitate biofilm growth. A range of detergents and cleaning brushes were used to see which would give the best results in the manual cleaning process. For all types of detergent used, the PULL THRU Cleaning Brush gave better results overall in each category, apart from the mean ATP when used with an enzymatic.

The Authors note on page 1289:

“Our data also support the role of friction in the cleaning process because the use of the pull-through channel cleaner left less organic debris than bristle brush, when evaluated by SEM. The flexible “discs” of the pull-through device would have better surface contact with the inner surface of the PTFE channel compared to the bristles of the traditional bristle brush used for cleaning. This may explain why the SEM images showed far less residual debris and bacterial forms when the pull-through device was used, regardless of which detergent was used.”

Alfa, Michelle & Singh, Harminder & Nugent, Zoann & Duerksen, Donald & Schultz, Gale & Reidy, Carol & DeGagne, Patricia & Olson, Nancy. (2017). Frontiers in Medicine. 4. 10.3389/fmed.2017.00191. 

This study investigated the sampling of duodenoscope channels. Though not directly related to the cleaning capabilities of the PULL THRU Cleaning Brush, the study provided some interesting findings.
On page four of the study it states:

“The pull-through channel cleaner was the most effective at removing fixed residuals in the borescope examination.”

And on page seven:

“In addition, the borescope assessment supports the initial data reported by Alfa and Olson (13) confirming that the use of friction (i.e., bristle brush or pull-through device) for sample collection of the channel is critical to ensure optimal removal of fixed residuals --regardless of what fluid is used or sample extraction”.

Cattoir, Lien & Vanzieleghem, Thomas & Florin, Lisa & Helleputte, Tania & de vos, martine & Verhasselt, Bruno & Boelens, Jerina & Leroux-Roels, Isabel. (2017). Infection Control & Hospital Epidemiology. 38. 1-8. 10.1017/ice.2017.115.  

This study also explored sampling techniques. On page four, the study notes:

“Based on our findings, it could be argued to replace standard cleaning brushes with PULL THRU Brushes for manual endoscope cleaning.  Because current evidence is limited, future research on the efficacies of different brush types for manual cleaning of flexible endoscopes is warranted.”