15 Dec 2016

The American Journal of Infection Control issue 44 (2016) pages e107 through e111, with following title: “Major Article Reproducible elimination of Clostridium difficile spores using a clinical area washer disinfector in 3 different health care sites.” discusses the opportunities for eradication of C-diff risks on the surfaces of traditional hospital (and nursing home) bedpans (and slipper-pan/fracture-pans/commode-pans/wash-basins/wash-bowls by extension).

The study lays out very clearly that only under the MOST PERFECT of circumstances, will the bedpan washer-disinfector (WD) be able to cope. The study shows a significant number of risk factors, limitations and complications which all, every single one, will drive down the disinfection performance significantly.

The study shows how complex it has become, with temperatures, with detergents, with loading of machines, with capacity (washing one or two pieces), with staff errors, with lack of response-time (bedpans ‘drying up’), with physical errors on the machines.

As a result of such studies, taking the ever-increasing costs of using washer-disinfectors into account, it is Curas recommendation to all healthcare facilities to commence the use of disposable alternative systems.

25 OCT 2016

Here at Curas we often get asked questions relating to the suprapubic method of urinary drainage, where the bladder is accessed via a small insertion (for men above the penis area, typically) rather an through the urethra.

There are two types of questions:

A) Is the suprapubic (SPT) method a better method?
A fairly large study in USA (2010), involving 179 patients suffering from spinal cord injuries, suggest that the two methods of catheterization are of same value and benefit/risk to the patient.

RESULTS: In all, 179 patients were identified. There was no significant difference between the two catheter groups in any areas in which they could be compared. There were catheter-specific complications specific to each group that could not be compared.

CONCLUSION: SCI (spinal cord injury) patients with a chronic catheter have similar complication rates of UTIs, recurrent bladder/renal calculi and cancer. Urethral and scrotal complications may be higher with UC; however, morbidity from SPT-specific procedures may offset benefits from SPT. Serum creatinine was maintained in both groups. Overall, bladder management for patients with chronic indwelling catheters should be selected on the basis of long-term comfort for the patient and a physician mind-set that allows flexibility in managing these challenges. (source: https://www.ncbi.nlm.nih.gov/pubmed/19823191)

Another question we often are asked; are there any need or benefit from using a specific suprapubic catheter?

The internet is full of statements that point in either direction, and as a conclusion we can say that to the best knowledge of Curas, there is no specific rule or trend in this area of medicine. It is our judgement that most SPT-specific procedures, worldwide, are carried out using a regular Foley catheter, sometimes following the initial penetration done by a stiffer, small-size intermittent Nelaton catheter, but not always.

For any specific questions, we always suggest patients to debate the issues with their urologist and medical team.