Common problems in clinical application of the hot

2022-09-22
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Common problems in the clinical application of paper plastic packaging

with the continuous development of disinfection and sterilization technology, packaging materials for sterilization and preservation are increasingly abundant [1]. Paper plastic packaging is one of the new materials used in clinic in recent years. This paper summarizes the materials, advantages, common problems and precautions of paper plastic packaging

1 material

paper plastic packaging bag is a special packaging bag made of medical grade paper and polymer plastic film. One side of the packaging bag is marked with a chemical monitoring indicator color code suitable for high-pressure sterilization, and the other side is marked with a chemical monitoring indicator color code suitable for ethylene oxide sterilization [2]. The models are flat and folding (large items can be placed) [3]. The specifications of flat paper plastic packaging mainly include 5.0cm, 7.5cm, 10.0cm, 15.0cm, 20.0cm, 25.0cm and 30.0cm. At present, imported materials from the United States, Germany, Finland, Italy and other countries are mostly used in clinical practice, and only a few domestic enterprises have production qualifications

2 advantages of paper plastic packaging

2.1 wide application range pressure steam and ethylene oxide sterilization are the two most commonly used sterilization methods in hospitals at present, and paper plastic packaging is suitable for both sterilization methods at the same time. All kinds of small treatment bags commonly used in clinic can be packaged with paper and plastic. Wang Hui et al. [4] reported that paper plastic single package sewing needles and blades are simple to operate and easy to store and use. Liu Chengjun and others [5] applied paper plastic packaging to field hospitals, believing that this material can prolong the storage period of sterilization packages, greatly reduce the sterilization workload under field conditions, reduce the risk of infection of the majority of commanders and soldiers, and effectively ensure the combat effectiveness of the army. Moreover, the paper plastic sterile bag is light and convenient for field medical teams to use when they get out of the army. Yue Haili et al. [6] reported that the effect of dental autoclaving with paper plastic single packaging is safe and reliable, and it can be used immediately in front of patients, which can enhance patients' trust in doctors and avoid unnecessary medical disputes. Wangxuehui et al. [7] believed that the sterilization of paper plastic packaging has a long period of validity, and it has more advantages in maintaining spare sterilized items in the operating room, but with higher profits

2.2 it is easy to use. The self-contained chemical indicator tape saves the trouble of pasting the chemical indicator tape outside the bag, and the transparent plastic surface consumes a large amount of electric energy. Look directly at the quantity and type of items in the bag and the discoloration of the chemical indicator card

2.3 it can effectively block bacteria. Paper plastic packaging forms a unique barrier because its material is a special porous arrangement, which can effectively isolate bacteria and other microorganisms, so that sterile items can be stored for a long time [8]. But at present, there is no final conclusion about the validity period of paper plastic packaging. According to the 3rd edition of 5 technical specifications for hospital disinfection 6: if the disposable paper plastic packaging material is proved to be able to block microbial infiltration, its validity period can be extended correspondingly, at least for more than half a year [9]. In order to verify the longest term of validity of paper plastic packaging, domestic scholars have studied this. Dai Lizhong [10] reported that no bacteria grew within 48 weeks after high-pressure steam sterilization of paper plastic sterile bags. Bai Xianhong et al. [11] reported that the items in the sterile package were still sterile within 24 months after the high-pressure steam sterilization of paper plastic packaging. He Shuyun et al. [12] reported that 5ml glass syringes packed in paper and plastic were sterilized with high-pressure steam and ethylene oxide and stored for 1 year. All bacterial cultures were negative, and the qualification rate was 100%. The research of Wei Jingrong and others shows that the domestic medical paper plastic packaging equipment has no bacterial growth within 90 days after pressure steam sterilization, and no bacterial growth within 360 days after ethylene oxide sterilization. Chenairong [14] reported that as long as the 3M paper plastic package is tightly sealed and sterilized with domestic pulsating vacuum high-pressure steam sterilization cabinet, the effect is reliable, and the sterility validity can be guaranteed for 6 months. Based on the literature and clinical experience, the author believes that as long as the sterile storage room meets the standard requirements, the paper plastic packaging items are safe and reliable after high-pressure steam sterilization for 6 months and ethylene oxide sterilization for one year. In addition, compared with ordinary cotton packaging, the biggest advantage of paper plastic packaging is that it can avoid the pollution of instruments and articles by cotton dust and other fibers

2.4 the cost of paper plastic packaging is low. It is usually mistaken that the cost of disposable paper plastic packaging is higher than that of reusable cotton packaging. However, after comparing the costs of traditional cotton packaging, imported paper plastic packaging and domestic paper plastic packaging, Zhou Qiuying and others [8] concluded that the cost of paper plastic packaging materials was 35.2% to 56.8% lower than that of cotton, of which domestic paper plastic packaging materials were 56.8% lower than that of cotton

3 common problems and precautions in the application of paper plastic packaging

3.1 common problems are mainly cracking of plastic seal and damage of paper surface. Yang Honglan [15] reported that 5% of the plastic sealing layer of paper plastic bags sterilized by pressure steam cracked during storage. Wang Fengqin and others reported that the air leakage rate of the opening of the paper plastic packaging sterilization package was 11.5%, 5 Safe installation and limit installation should be flexible and firm; Among them, 85% occurred during sterilization and 15% occurred during storage. Zheng Cuiyun et al. [17] found that 65 paper plastic packaging bags were damaged, accounting for 1.1% by investigating the sterilization packages of 5680 paper plastic packaging bags

3.2 precautions in view of the above problems, the following requirements should be followed in the use of paper plastic packaging: choose to use paper plastic packaging materials approved by the national health administration department; Before use, use biological indicators to verify the sterilization effect before use; Stored in a cool and ventilated environment with a temperature of 18e~22 ℃ and a relative humidity of 50%~75%. If stored in a high temperature and dry environment for a long time, the paper toughness will be reduced, and the plastic surface will age and become brittle; Carefully check whether there is damage before use to avoid dampness; Paper plastic bags with appropriate specifications shall be selected according to the size of sterilized items. After the items are put in, a space of 3cm~5cm shall be reserved up, down, left and right. It is not suitable to load heavy instruments. Sharp instruments shall be properly protected before loading to avoid puncturing the packaging bag; When using the thermal sealing machine, the temperature should be controlled at 180e~220e, and the speed should be medium to avoid repeated thermal sealing; When the paper plastic packaging bag is placed into the sterilization basket, it should be placed vertically, and the paper should be placed in turn facing the plastic surface, not too crowded; Avoid dragging when taking and placing sterile bags. Heavy bags should be taken with both hands

to sum up, the advantages of using paper plastic packaging outweigh the disadvantages. As long as the adverse factors are eliminated in the production, sterilization and preservation, this kind of packaging has an exhibition area of 22000 square meters. At present, the material is an ideal material for quality assurance and consumption reduction, which is worth promoting

reprinted from: chinesenursingresearc

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