[Evaluation of the quality of the process of stoma demarcation and late complications in ostomized patients]. / Avaliação da qualidade do processo de demarcação do estoma intestinal e das intercorrências tardias em pacientes ostomizados.

Following the characterization of adults with an intestinal stoma who were registered in the Program of Education and Support to Stomized Patients, the authors developed a descriptive study in order to evaluate the results of the process of intestinal stoma demarcation as well as to analyze late complications. The sample was formed by 50 subjects, 76% of whom had colostomies and 34% had ileostomies. Regarding the stoma location, 12% did not demonstrate the scientific specifications indicated for the distance from the waist line, 2% for the iliac crest and 2% for the surgery scar. Late complications appeared in 44% of the cases, such as: 28% of peristomal hernias, 16% of stoma prolapses and 4% of skin hyperemias.

The presterilization microbial load on used medical devices and the effectiveness of hydrogen peroxide gas plasma against Bacillus subtilis spores.

OBJECTIVES: To determine the microbial load found on used critical medical devices (5 spinal anesthesia needles, 21 catheters, and 28 sheaths) prior to sterilization and to evaluate the effectiveness of hydrogen peroxide gas plasma against inoculated Bacillus subtilis var globigii (American Type Culture Collection 9372) spores. METHODS: Membrane filter and pour-plate methods were applied to estimate total microbial loads (aerobic and anaerobic, mesophilic and thermophilic, vegetative and spore forms). Spinal anesthesia needles (102 units) and sheath components (61 units) were inoculated with a suspension of B. subtilis spores. After drying, the devices were sterilized with hydrogen peroxide gas plasma. RESULTS: Higher counts of aerobic, mesophilic, and fungal organisms were recovered when the drying period was insufficient. Anaerobic spores were not found in any analyzed presterilization items. The hydrogen peroxide gas plasma effected a 5 to 7 log10-fold reduction in B. subtilis spore counts in well-dried needles and sheath components. CONCLUSIONS: The success of hydrogen peroxide gas plasma sterilization depends mostly on educating the staff to assure well-cleaned and dried reusable medical devices, allowing penetration of the hydrogen peroxide gas plasma into the critical points of the items and providing a reduction in organisms.