Abstract
Study Design
Systematic Review.
Objectives
To review systematically the clinical evidence of the effectiveness of various intermittent catheter cleaning methods that have been proposed as methods to prepare catheters for reuse.
Methods
A keyword search in Medline, Excerpta Medica dataBASE, the Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane Central Register of Controlled Trials, was undertaken to identify all English, Russian and German language literature evaluating the effectiveness of various intermittent catheter cleaning methods. Studies selected for review included analytical experimental, prospective cohort and cross-sectional. Cleaning methods reviewed included heat-based sterilization, chemical cleaning solutions, mechanical abrasion, photocatalytic sterilization, and combined methods.
Results
Overall, 12 studies were included. Heat-based sterilization and mechanical abrasion methods were either not effective or damaged the physical properties of catheters. Two studies reported evidence that their chemical cleaning methods (i.e., soaked catheters in a 70% alcohol solution for 5 min or combined approach detergent wash followed by soaking in Milton sterilizing fluid also known as the Milton method) both preserved the structural integrity of their catheters and were bactericidal.
Conclusions
Numerous cleaning methods resulted in the destruction of catheters. However, there are two reported cleaning methods, submersion for 5 min in 70% alcohol and the “Milton method”, that eliminate bacterial colonization while leaving the physical properties of the catheters unchanged. While these cleaning methods are promising, each was published in just one study, therefore higher-powered / longitudinal studies confirming the safety and efficacy of these cleaning methods must be obtained before current clinical recommendations can be modified.
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Data availability
The datasets generated and / or analysed during the current study are available from the corresponding author.
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Acknowledgements
MG was supported by a University of British Columbia, Faculty of Medicine Summer Student Research Program Award. Andrei V. Krassioukov holds the University of British Columbia, Faculty of Medicine, Department of Medicine, Endowed Chair in Rehabilitation Medicine.
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MG: Study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript and critical revisions. MW: Study conception and design, acquisition of data, analysis and interpretation of data, critical revisions of the manuscript, and supervision. AVK: Study conception and design, acquisition of data, analysis and interpretation of data, critical revisions of the manuscript, and supervision. All authors approve the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Andrei V. Krassioukov is an advisory board member for Coloplast and Wellspect. All other authors declare that they have no conflict of interest.
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Grasdal, M., Walter, M. & Krassioukov, A.V. The microbiological and physical properties of catheters for intermittent catheterization: a systematic review on the impact of reuse and cleaning. Spinal Cord 60, 581–593 (2022). https://doi.org/10.1038/s41393-021-00740-3
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DOI: https://doi.org/10.1038/s41393-021-00740-3
