be better for patient safety and infection control.
6. Clean and sterilize. As with any procedure, the importance
of both cleaning and sterilizing equipment can't be overstated. All non-
disposable instruments should be washed to remove bioburden and
thoroughly rinsed. All cannulated instruments and reusable tubings
and handpieces should be washed and copiously flushed between
cleaning and sterilization. When the TASS (toxic anterior segment syn-
drome) outbreak some years back was studied, it was found that
some of the problems were associated with improper cleaning of the
injectors, cannulas and phaco and irrigation/aspiration handpieces —
that the viscoelastic used during procedures was not being cleaned
adequately from those instruments. If an instrument is sterilized with-
out having been rid of bioburden, it can release an endotoxin the next
time it's used.
7. Powdered gloves should be gone. We phased ours out
quite a while ago, and now, of course, the FDA has made it clear that
all powdered gloves should be eliminated from surgical procedures.
They're another culprit that's been connected to endophthalmitis, so if
you haven't gotten rid of yours yet, what are you waiting for?
OSM
1 1 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7
Ms. Beltramba (ebeltramba@amsurg.com) is the center director at the Eye
Surgery and Laser Center in Winter Haven, Fla.
