The advantages of enzymatic detergents

To minimise this risk, effective cleaning and disinfection of flexible endoscopes must be undertaken. Dr Tim Sandle explains why, for this process to be effective, several steps need to be followed in a controlled manner. 

The first step, where a detergent is used at the pre-washer / disinfectant stage, is critical for the removal of soil and in preventing a biofilm community from developing.2 This step requires the use of a suitable detergent and following an agreed protocol.3 A detergent used for the cleaning of endoscopes should be of a medical device grade and carry a CE mark, be low-foaming (to help ensure the active chemicals remain in contact with the target surface), non-corrosive (and avoid discolouring the endoscope) and have proven cleanability. Detergents should always be used according to the manufacturer’s instructions, observing carefully the recommendations relating to detergent concentration, temperature and expiry date.

It is not sufficient to just soak the endoscope in a detergent solution; a degree of agitation is required, such as using a wipe applied to all external surfaces of the endoscope, together with uniform application of the detergent to ensure that all surfaces both internal and external, are treated. A key factor in determining how effective the cleaning process will be, relates to the type of detergent selected and its formulation. There is an essential difference between enzymatic and non-enzymatic (‘neutral’) detergents. Generally, enzymatic detergents are considered to be more effective due to their ability to digest different types of soils and therefore facilitate the cleaning process. This article examines some of the differences between detergents used for the manual cleaning of flexible endoscopes, and considers some of the factors needed for the safe and effective application of detergents.