What are the modern agents for disinfection of operating theatres?

Dear,

Nowadays in Belgium the following classes of disinfectants are used for horizontal surfaces i.e. floors - when and where necessary of course - :

1. Aldehydes:
   They are very effective but care must be taken not to exceed the ceiling exposure limit (TLV-C). They are used in combination with other aldehydes i.e. fomaldehyde, glutaraldehyde, glyoxal and/or in combination with other disinfectants i.e. quaternary ammonium compounds.
2. Quaternary ammonium compounds:
   They are in principle less effective but also less toxic than aldehydes. Their detergent action is an advantage. They are used most of the time in combination with other disinfectants i.e. alcohols, amfoteric compounds and/or aldehydes.

In our country chlorine compounds are not in use anymore for the disinfection of floors in the OR. They are incompatible with different surfaces, corrosive, not stabile and quickly inactivated by organic matter. But chlorine has a wide activity and can offer an excellent and cheap alternative in some cases.

For the disinfection of other horizontal surfaces we often use ethylalcohol 70% or the cetrimide - chlorhexidine combination.

The APIC guideline for selection and use of disinfectants can be helpful literature. See: www.apic.org/pdf/gddisinf.pdf

Kind regards,
Wim Renders

There are several groups of agents, which can be used to disinfect operating theatres:

Aldehydes:
They are very effective, and normal dosages of 0.5%, or in some cases 1.0% don't exceed the MAK (maximal working place concentration). But in case of an infectious disease working with higher concentrations is mostly necessary.

Quaternary ammonium compounds (qac)
Most modern surface disinfecting products contain qac. They are less effective but also less toxic than aldehydes. Qac are cationic tensides and do have a good detergent power. Normally they are combined with other active ingredients like alcohol, aldehydes, or amines.

Amine:
They are similar to qac. In most cases amines are combined with qac. Amines have very good cleaning power, the usage of an additional cleanser is therefore normally unnecessary. But attention: Amines react with aldehydes (especially glutaraldehyde) ! Before performing a switch from aldehydes to amines an intensive cleaning of all surfaces is absolutely necessary. In cases of contagious diseases aldehyde-bases disinfectants are not appropriate, here the usage of oxygen releaser is a better choice.

Alcohol:
They are normally used in combination of n-propanol, iso-propanol and/or ethanol. Alcohol is a fast acting ingredient but is only recommended for small surfaces (not more than 50ml/m² surface). The epavorated alcohol might built explosive gas-mixtures.

www.bode-chemie.de

Dear,

Disinfection of the O.R floors is done only in case of blood spill and then with chlorine 1000 ppm. This, because viral contamination is possible and then a lower concentration is not effective. If you still want to disinfect the floors, then you can use a chlorine solution of 250 ppm. We don't use aldehydes because ot their toxicity. We don't use quaternary ammonium compounds because of their limited spectrum. So only chlorine is left over or alcohol, for small surfaces. Some people bring the routine disinfection of the O.R. floors up, but we are not for it because it is not meaningful. The floors are recontaminated in no time.

Thea Daha
WIP (www.wip.nl
LUMC - C9-43
Postbus 9600
2300 RC Leiden
The Netherlands