Endoscopes: pre-clean the unseen

Kerry Dolan provides an insight into the problem of biofilms and discusses why endoscope pre-cleaning is crucial for patient safety.

Pre-cleaning is a fundamental step in an endoscope's reprocessing journey. The pre-clean begins at the bedside post-procedure and should be carried out immediately after the removal of the insertion tube from the patient. Failure to perform this simple task could pose a serious threat to patient safety due to the growth of potentially dangerous, invisible bacteria.

Current UK guidelines recommend that reprocessing flexible endoscopes with lumens is split into three different areas:

1. Manual cleaning — this includes brushing with a single-use cleaning device, rinsing, and exposing external and accessible internal components to a low foaming detergent, which is compatible with the endoscope. This procedure is unstandardised and relies on the competence of the endoscopy unit staff.

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