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Reviewer's Choice

Chou HW. et al., 2022: Experimental Observation of Isolative Efficacy of a Solid Coupling Medium in Extracorporeal Shock Wave Lithotripsy-Implications to Nosocomial Infection Prevention.

Chou HW, Huang CL, Lin YC, Lin YE, Chen WC.
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan.
Division of General Internal Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan.
Department of Medical Humanities and Education, Kaohsiung Medical University, Kaohsiung 807377, Taiwan.
Graduate Institute of Human Resource and Knowledge Management, National Kaohsiung Normal University, Kaohsiung 802561, Taiwan.
CleanWave Medical Co., Ltd., Kaohsiung 806613, Taiwan.
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.

Abstract

Introduction: Extracorporeal shock wave lithotripsy (ESWL) is a well-established, popular treatment choice for renal stones. Traditionally, the semi-liquid gel is used as a coupling medium in ESWL. During ESWL, body fluid or blood might transmit between the patients when the probe or gel used in the procedure is contaminated and cause potential nosocomial infections. To solve this problem, we developed a solid coupling medium (isolation coupling pad, referred to as "icPad") between the patient's skin and the probe as a shock wave transmission medium to prevent contamination. This study aimed to investigate the isolative efficacy of the icPad in blocking the permeation of microbes. Method: Rhodamine 6G (a fluorescent dye) was used as a tracer to simulate the microorganisms. The penetration of the fluorescent dye on the longitudinal section of the icPad was observed by a microscope after the dye was placed on the body side of the icPad for 40 min. After the shock wave, icPad was extracted with 75% ethanol, and fluorescence intensity was measured with a fluorescence spectrometer. Results: Our results revealed that the body side of icPad is free of fluorescent dye during lithotripsy. Qualitative analysis results confirmed that icPad has an isolative effect on simulating contaminants such as bacteria or viruses. Conclusion: In this in vitro phantom study, a proprietary icPad can be an isolative coupling medium and is speculated to avoid cross-contamination of bacterial or viral infection during ESWL.
Pathogens. 2022 Sep 27;11(10):1103. doi: 10.3390/pathogens11101103. PMID: 36297160. FREE ARTICLE

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Comments 1

Hans-Göran Tiselius on Friday, 10 February 2023 09:40

This report is interesting, not only because it describes a device that ensures safe contact between the shock wave head and the patients body surface. For the Storz SLX lithotripters this device is not necessary, because there is already a plastic membrane between the shock wave head and the patient, a plastic shield that only needs traditional cleaning and disinfection.

For lithotripters of other types, the icPAD appears to be a useful device. The advantage is to avoid bacterial and other infective contamination. But it also provides a new idea by means of which gas bubbles in the interface can be avoided.

Although theoretically interesting it is obvious that the solid coupling medium so far has not been used clinically, but previously published in vitro studies are promising.

Any information on the cost of this device cannot be found.

Hans-Göran Tiselius

This report is interesting, not only because it describes a device that ensures safe contact between the shock wave head and the patients body surface. For the Storz SLX lithotripters this device is not necessary, because there is already a plastic membrane between the shock wave head and the patient, a plastic shield that only needs traditional cleaning and disinfection. For lithotripters of other types, the icPAD appears to be a useful device. The advantage is to avoid bacterial and other infective contamination. But it also provides a new idea by means of which gas bubbles in the interface can be avoided. Although theoretically interesting it is obvious that the solid coupling medium so far has not been used clinically, but previously published in vitro studies are promising. Any information on the cost of this device cannot be found. Hans-Göran Tiselius
Monday, 20 May 2024