Evaluating the Potential, Applicability, and Effectiveness of Ozone Sterilization Process for Medical Devices

Sterilization of Human Amniotic Membrane Using an Ozone Hydrodynamic System

Human amniotic membrane (hAM) is an important biomaterial for Tissue Engineering, due to its great regenerative properties and potential use as a scaffold. The most used procedure to sterilize biomaterials is gamma-irradiation, but this method can affect several properties, causing damage to the structure and reducing the growth factors. The present work evaluated the efficiency of a new method based on ozonated dynamic water for hAM sterilization. HAM fragments were experimentally contaminated with Staphylococcus aureus, Escherichia coli, Candida albicans, Staphylococcus epidermidis, and Clostridium sporogenes (106 CFU/mL) and submitted to sterilization process for 5, 10 and 15 min. The analyses did not reveal microbial activity after 10 min for S. aureus and C. sporogenes and after 15 min for E. coli and S. epidermidis. The microbial activity of C. albicans was reduced with the exposure time increase, but the evaluated time was insufficient for complete sterilization. The depyrogenation process was investigated for different ozonation times (15, 20, 25, 30, and 35 min) to evaluate the ozone sterilization potential and presented promising results after 35 min. The ozone effect on hAM structure was evaluated by histological analysis. A decrease in epithelium average thickness was observed with the exposure time increase. Furthermore, some damage in the epithelium was observed when hAM was exposed for 10 and 15 min. It can indicate that ozone, besides being effective in sterilization, could promote the hAM sample's de-epithelization, becoming a possible new method for removing the epithelial layer to use hAM as a scaffold.

Ozonated water in disinfection of hospital instrument table

Purpose

The walls, ceiling, and floor of a surgical environment, as well as the surfaces used in this place, must be submitted to a disinfection protocol to minimize nosocomial infections. Health regulations recommend two stages; the first is characterized by cleaning procedures, mainly using an enzymatic detergent, and the second is use of a disinfection agent. Ozone is a natural substance that has a relevant oxidative property for inactivating microorganisms and has emerged as an interesting agent in the hospital environment. Compared with conventional chemical products for disinfection, ozonated water has advantages such as a lack of storage control, disposal, and handling safety. The objective of this study was to use ozonated water as a disinfectant agent on a hospital metal surface, in comparison with 70% alcohol.

Methods

The degree of disinfection of the metal surface was quantitatively analyzed with use of an instrument by bioluminescence for a disinfection test.

Results

Qualitative terms indicated gram-positive cocci microorganisms and yeasts, suggesting that bacteria and fungi from the environment were identified. After the use of ozonated water as a disinfectant, the quantitative analysis indicated values below 100 RLU, showing evidence of a surface suitable for use in surgical procedures.

Conclusion

The use of ozonated water as a disinfectant agent for a metal surface in a hospital environment showed more effectiveness than 70% alcohol. Thus, ozonated water is a promising agent for disinfecting surfaces in surgical environments.

Ozone application in different industries: A review of recent developments

Ozone - a powerful antimicrobial agent, has been extensively applied for decontamination purposes in several industries (including food, water treatment, pharmaceuticals, textiles, healthcare, and the medical sectors). The advent of the COVID-19 pandemic has led to recent developments in the deployment of different ozone-based technologies for the decontamination of surfaces, materials and indoor environments. The pandemic has also highlighted the therapeutic potential of ozone for the treatment of COVID-19 patients, with astonishing results observed. The key objective of this review is to summarize recent advances in the utilisation of ozone for decontamination applications in the above-listed industries while emphasising the impact of key parameters affecting microbial reduction efficiency and ozone stability for prolonged action. We realise that aqueous ozonation has received higher research attention, compared to the gaseous application of ozone. This can be attributed to the fact that water treatment represents one of its earliest applications. Furthermore, the application of gaseous ozone for personal protective equipment (PPE) and medical device disinfection has not received a significant number of contributions compared to other applications. This presents a challenge for which the correct application of ozonation can mitigate. In this review, a critical discussion of these challenges is presented, as well as key knowledge gaps and open research problems/opportunities.

Enhancing Staphylococcus aureus sterilization of stainless steel by the synergistic effect of surface structure and physical washing

Staphylococcus aureus infection is common in the clinical environment. It has been shown that the presence of micro/nano structures on material surfaces promote bacterial adhesion resistance. Herein, we assessed the S. aureus adhesion properties on laser micro/nano structured stainless-steel (316 L) surfaces after mechanical rotation and ultrasonic washing. The interaction force between S. aureus and structured surfaces was evaluated. A high concentration S. aureus solution was used to evaluate the bacterial sterilization efficiency after film formation on the stainless-steel surface. After 24 h of incubation, S. aureus films were formed on material surfaces. The comparison of static washing, surface mechanical rotation, and ultrasonic washing showed a decrease of S. aureus adhesion on the polished and laser induced periodic surface structures. However, S. aureus adhesion on the micro/nanoparticle surface after mechanical rotation washing did not display any obvious change compared to the polished one. Additionally, specimens after ultrasonic cleaning showed clear antibacterial adhesion than mechanical rotation. After the ultrasonic sterilization process, the laser induced periodic laser surface sample showed optimal bacterial adhesion inhibition. Finally, in vitro tests showed that the biocompatibility of the laser-induced structured surface did not change significantly from the polished surface one.