A SUCCESSFUL STORY - STEQ America · 2018-10-10 · in steam and low temperature sterilization. We...

MATACHANA GROUP CORPORATE NEWS No. 05 · 2018

www.matachana.com

FROM POUPINELTO AUTOCLAVE

STORY BEHIND THE CREATION OF A STERILIZATION CENTRAL

IN THIÈS (SENEGAL)

MAT LDWASHERSTHE NEW MARKET STANDARD

A SUCCESSFUL STORYLTSF STERILIZATIONIN ORIENTAL ASIA

NEW RUMEDTO SERVICE THE4 CHUAC HOSPITALES

CONTENTS

4 MATACHANA, A LEADING COMPANY IN LATIN AMERICA

For over 40 year, a key region in developing and establishing the company on an international scale

7 UNDER ONE NAME, ONE SPIRIT: MATACHANA Unifying the various brands from

the group 8 TOP 10 DE RISKS ASSOCIATED WITH THE

HEATHCARE TECHNOLOGIES List by the ECRI Institute for 2018

9 MAT LD WASHERS, THE NEW MARKET STANDARD

- Protect the environment- Increase productivity - Economic savings

10 A SUCCESSFUL STORY: LTSF STERILIZATION IN ORIENTAL ASIA

30% of the medical devices from the sterilization centrals are sterilized with low temperature processes.

14 NEW RUMED TO SERVICE THE 4 CHUAC HOSPITALS Complejo Hospitalario

Universitario de A Coruña 16 INVISIBLE SURGERY

Towards the robotics of flexible endoscopy platforms

17 PROCESS VALIDATION in the automatic washers of flexible endoscopes and storage cabinets

18 TURKMENISTANAnother great success in Central Asia

20 FROM THE POUPINEL TO THE AUTOCLAVEThe story behind the creation of a sterilization central in the Hôpital Saint Jean de Dieu de Thiès (Senegal)

22 COEMHospital Notre Dame de la Santé Dschang - West Cameroon

23 INSTITUTO DE SALUD CARLOS III opens its new research center

26 FAIRS AND CONGRESSES OUTSTANDING EVENT

Get to know some of the most important events in which MATACHANA has participated during the year 2017

MATACHANA PROVIDES SERVICES IN OVER 110 COUNTRIES. OUR OFFICES ARE IN SPAIN, FRANCE, GERMANY, ITALY, USA, ARGENTINA AND MALAYSIA

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2 · MATACHANA MAGAZINE · Nº 05 · 2018

STEADY GROWTH ON THE 5 CONTINENTS

We close 2017 with excellent results at a business level, as a consequence of the trust placed by clients from more than 110 countries and a great deal of workmanship of the human talent that makes up this company, as well as the wide network of distributors that have been able to provide a quality service at all levels. By means of this Editorial, we extend our gratitude to you. Without your actions, we could not possibly move forward in our mission and social commitment.

We are therefore facing 2018 with great enthusiasm and hope, trusting that we will be able to live up to what our clients' day-to-day requirements. We overcome barriers through a tireless work on the 5 continents, implementing infection control solutions that help improve the healthcare quality within the hospital environment and contributing to the research of so many centres that have placed their trust in our equipment and integral solutions.

In this new MAGAZINE edition, we present articles signed by great professionals from the sectors where we operate, which will help us to gain a better grasp of the excellent work they do every day in their respective centres and to which our society owes so much.

In addition, we hope you will enjoy learning about the latest projects carried out by MATACHANA in both the Healthcare and Life Science markets. New projects through which you will be able to discover the implementation of the solutions and equipment we proudly presented in previous editions of this magazine.

Enjoy your reading!

STAFF

EDITOR IN CHIEFMarino Alonso

COORDINATOR AND EDITORMaria Teresa Sandalinas

DESIGN AND LAYOUTCarme Garcia

EDITORIALManuel MatachanaMarino AlonsoElena LorenzoEnric HernándezJordi PolEnrique GonzálezJosé F. NogueraJorge ÁlvaroAhmed MenekbiRosa AlsedàTomás EpeldeguiJosé León PaniaguaMª del Pilar Pallarés

TRANSLATION COORDINATIONCatherine Planas

COVER Photo courtesy of Yasuhiro Kurihara, Japan.

Mount Fuji is located in central Japan. It is classified as a low-risk active volcano. The last recorded eruption dates from February 1708. At an altitude of 3776 meters, it is the highest peak on the island of Honshu

and throughout Japan. Mount Fuji is the symbol of Japan and has been considered sacred since ancient times. Nowadays, it is an important tourist destination, with a large number of foreign visitors. The first known ascent to Mount Fuji dates from 663 and was made by a Buddhist monk. The ascent can last between three and eight hours and the descent between two and five.

From left to right:

Juan Antonio Matachana, President / CEO MATACHANA GROUP

Arantxa Matachana, Treasury Manager MATACHANA GROUP

Manuel Matachana, Vice President MATACHANA GROUP

HEADQUARTERS MATACHANA GROUP

Almogàvers, 174 | 08018 Barcelona Spain | Tel. +34 934 868 [email protected]

Legal Deposit: B 4252-2014

2018 · Nº 05 · MATACHANA MAGAZINE · 3

MANUEL MATACHANAVice PresidentMATACHANA GROUP

MATACHANA, A LEADING COMPANY IN LATIN AMERICA

For over 40 years, the Latin American market has been a key region for MATACHANA in developing and establishing the company on

an international scale. In fact, the company’s first subsidiary outside of Spain was set up in Buenos Aires, Argentina, in 1982. It started with a sales team and a technical service to directly deal with the hospital facilities set up there.

Today, MATACHANA is present in all countries in Latin America, primarily through a network of Distributors that work in Healthcare and Life Science.

These companies are committed to Infection Control in their respective countries, and continue to implement the latest innovations both in washing and in steam and low temperature sterilization.

We have undertaken major projects in Sterilization Centrals recently, which we have revealed in previous editions of this magazine. And the latest projects are a testimony to our commitment to this market, in which MATACHANA devotes its best efforts and support at all levels. Examples from the past 6 months: Hospital de Quito Sur, in Ecuador; Hospital

Occidental, in Nicaragua; Hospital de Manta, in Ecuador; Hospital de Antofagasta, in Chile; and Clínica El Bosque, in Colombia. These all represent large hospital projects that contribute to increasing the quality of care in their respective countries, and contributing to the well-being of society.

We can take great pride in saying that the name MATACHANA is now widely spread around the world, and highly renowned among users.

With the recent opening of a second subsidiary in the USA, MATACHANA is demonstrating its devotion to the Americas, and its continued commitment to setting up Infection Control solutions in the hospital and Life Science markets.

We will continue to invest resources and efforts into maintaining our position of leadership in this part of the world that has already given us so much, and where we continue to feel a deep commitment.

Hospital de Manta, in Ecuador Hospital de Manta, in Ecuador

Hospital de Antofagasta, in Chile

New RUMED in the Hospital del IESS Quito Sur, in Ecuador New RUMED in the Hospital del IESS Quito Sur, in Ecuador

Hospital Occidental, in Nicaragua


www.matachana.com

matachanaintegral solutionsmatachana integral solutions

LIFE SCIENCE

LABORATORIES

PHARMARESEARCHCENTERS

INDUSTRYBIOSAFETY

WASHING

CONSUMABLES

TRACEABILITY

STERILIZATION

INFECTIONCONTROL

SPECIALBIOCONTAMINATED

WASTE TREATMENT

HEALTHCARE

ANATOMICALPATHOLOGY & MORGUE

UNDER ONE NAME, ONE SPIRIT:MATACHANA

Our company has already come a long way in recent history, and since the very star t we have been growing, nationally

and internationally, thus consolidating our global presence. Throughout this evolution we have had dif ferent names and purposes, both due to the types of business, types of acquisitions or, in a nutshell, to the natural passage of time. From ‘Comercial Matachana’ on day one, to names such as FABELHS for one of our factories and WEBECO for our German subsidiary, which became par t of the Group in 2000, various dif ferent names have formed par t of our legacy.

Over the past few years we have been working on unifying our products under the same flag, and on transmitting a single image as a common denominator across the whole company. As a result, unifying our brand under a single name was the final step to take in consolidating ourselves into what we are, a world leader in Infection Control for Healthcare and Life Science. A company that of fers Integral Solutions UNDER A SINGLE NAME: MATACHANA.

It has not been a simple transition, given that many of our brands have their own history and, in some cases, a well-established tradition in their markets. But we have all taken on this challenge as one of the key objectives for securing our future. The brand’s unification strengthens our image, and of fers a wide range of products under a single name.

We have been a family company since our origins. This forms part of our very essence, and is a key premise for our future. And all families have a common denominator in their name to feel united in their roots and expectant for what is to come. And this is what we have achieved for 2018 onwards. Congratulations everybody!

We invite you all to visit our website www.matachana.com where this philosophy is already being implemented.

MARINO ALONSODirector of Marketing & Competence Center MATACHANA GROUP


clean and disinfect and/or sterilize instruments can lead to the spread of deadly infections. In this regard, special attention must be paid to the following areas:

• The cleaning step, which is largely manual and technique-dependent. If biologic debris is not fully removed, residual soil can harden, making subsequent disinfection ineffective.

• Endoscope storage: Moisture trapped in the channels of an endoscope can promote the proliferation of any microbes not eradicated by reprocessing. The ECRI Institute recommends establishing qualitative inspections that include visual assessments and the use of biochemical testing, and introducing measures to dry endoscope channels after reprocessing.

At No. 3, the ECRI Institute highlights that bed and stretcher mattresses can remain infected by body fluids and microbiological contaminants. Covers are cleaned and disinfected, but this is not common for mattresses. If the integrity of a mattress cover is compromised, the mattress underneath can become contaminated and remain so for subsequent patients.

The other dangers described are:

4. Missed alarms from inappro-priately configured secondary notification devices and systems.

5. Improper cleaning that causes device malfunctions, equipment failures, and potential for patient injury.

6. Unholstered electrosurgical active electrodes that can lead to patient burns or fires if the ESU is inadvertently activated.

7. The inadequate use of digital imaging tools may lead to unnecessary radiation exposure.

8. Bar-coded medication admi-nistration (BCMA) systems help clinicians verify at the point of

Coinciding with the recent publication of the TOP 10 list issued by the

ECRI (Emergency Care Research Institute), we have included this report again to cover important security aspects related to the use of medical devices.

The number 1 spot for 2018 is taken by the cybersecurity threats from ransomware, which restrict access to the files in the affected system.

In a healthcare environment, a malware attack can significantly impact care delivery by rendering health IT systems unusable, by preventing access to patient data and records, and by affecting the functionality of networked medical device. Furthermore, such attacks can disable third-party services, disrupt the supply chain for drugs and supplies, and affect maintenance, monitoring and infrastructure systems. Such disruptions can lead to canceled procedures and altered workflows. This can damage equipment and systems, expose sensitive data, and force closures of entire care units, with a subsequent risk to patients.

Position 2 repeats the failures related to flexible endoscope reprocessing, which expose patients to a significant risk of infection. This threat has been in the TOP 3 on the ECRI list for more than 3 years. Failure to

care that the medications to be administered match provider orders. Used incorrectly, BCMA’s safety advantages can be completely negated.

9. A lack of attention when implementing networked medical devices and information systems can lead to incorrect or incomplete data transfers and other data communication errors. Such errors can delay diagnosis or treatment or prompt a misdiagnosis, affecting patient safety.

10. Enteral feeding tubing can be inadvertently connected to patient lines intended for other purposes, sometimes with fatal consequences.

From this list, we would like to highlight the importance of cleaning-related failures.

The exposure of medical devices and other equipment to improper cleaning methods and/or incompatible cleaning products can lead to:

• The premature deterioration of a device’s nonmetallic parts, which can lead to the weakening and ultimate breakage of the parts, as well as other associated damage or malfunctions.

• A failure of device electronics or power supplies, resulting from component damage or fluid intrusion.

• Adverse effects from residual surface debris or cleaning residue, which can cause equipment and safety failure, power supply interruption and excessive alarms.

The risk of harm to patients and staff, and the often substantial costs to replace damaged devices, outweighs the challenge of implementing safe and correct cleaning.

TOP 10 RISKS FOR 2018 ASSOCIATEDWITH HEALTHCARETECHNOLOGIES

ELENA LORENZOInfection Control ManagerMATACHANA GROUP

10


MAT LD WASHERS,THE NEW MARKET STANDARD

ENRIC HERNÁNDEZProduct Manager Washing SystemsMATACHANA GROUP

"PROTECT THE ENVIRONMENT, INCREASE PRODUCTIVITY, ECONOMIC SAVINGS"

Protect the environment:Minimize the consumption of water,chemicals and energy.

Increase productivity: Standard machine without a preheating tank, able to per form a full cycle, including pre-wash, wash, rinse, thermo-disinfection 1 min / 90 °C and highly ef ficient drying in45 minutes.

Economic savings: Reduced consumption ofenergy, water and chemicals allowsus to cover up to 100% of the cost of equipment in its useful life.

These were the three pillars on which we based the new MATACHANA MAT LD compact washers launch project. Today, it is a reality in full expansion. Each day it is earning more trust from users and technicians around the world, and demonstrates that the project pillars are an innovative step to improve the provisions of the current equipment on the market.

The widespread acceptance of the launch of this new washer line around the world in 2017 confirms that we have established a new path, in which all manufacturers should orient their next steps.

In 2018, we will welcome the MAT LD100 (compact washer with 8 baskets) and MAT LD2000 (washing cabin for trolleys and instruments) to the family. These devices have been built on the same pillars that will characterize our entire product line, and which will lay the foundations for a promising future.

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MAT LD100 MAT LD500 MAT LD2000MAT LD60 MAT LD90 MAT LD1000


JORDI POLManaging Director Asia Pacific SDN BHD MATACHANA

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A SUCCESSFUL STORY:LTSF STERILIZATION IN ORIENTAL ASIA

Temperature sensitive products need to be steri-lized by a low temperature sterilization process, such as the ethylene-oxide and the steam-formal-

dehyde process. The use of ethylene-oxide sterilizers in the hospital has been diminishing due to the long process duration with a lengthy degassing phase and the dangers connected to the toxicity of this gas. The low-temperature-steam-formaldehyde (LTSF) sterili-zation process emerged as an early alternative to the ethylene-oxide process in Oriental Asia in the last few years, specially in China and Japan.

The LTSF-sterilization process has been scrutinized in many research projects all over the world, at first by original scientific work at the Robert-Koch-Institute in Germany, and later in numerous countries as in Japan at Tokyo University by Dr. Kobayashi in 1977. Numer-ous publications have shown its high microbicidal ef-ficacy and the extraordinary penetration performance of the sterilizing agent. Later in 2004 Dr. Kamitani from Okoyama University Hospital also conducted a review on LTSF sterilization concluding highly positive re-sults; specially for the japanese market. A publication

MATACHANA, Low Temperature Sterilization Specialists

1975 1985 2000 2015 2016 2017 20181992

Ethyleneoxide

Combined steam & 35% formaldehyde

Steam & 2% formaldehyde



130HPO®

Hydrogen peroxide& plasma

50HPO®


Steam &2% formaldehyde

HIGH SPEED

We have travelled a long way together through the low temperature sterilization. Many thanks for your trust!


Takayuki Morita, Senior Vice President of UDONO LIMITED, promoting LTSF in Trade show HOSPEX'17

MATACHANA, Low Temperature Sterilization Specialists

1975 1985 2000 2015 2016 2017 20181992

Ethyleneoxide

Combined steam & 35% formaldehyde




130HPO®


50HPO®


Steam &2% formaldehyde

HIGH SPEED

We have travelled a long way together through the low temperature sterilization. Many thanks for your trust!

presented by Dr. Kanemitsu during the WFHSS 2012, a comparative study of current low temperature steri-lization methods, aimed to compare and re-evaluate the penetration efficacy of the latest low temperature sterilization technologies, and to discuss their appro-priate application for hollow medical devices, such as the flexible endoscope, concluded that LTSF is the right method for such application. Due to its process capabil-ities LTSF-sterilization has become today a method of choice for flexible endoscopes manufacturers as Olym-pus, Pentax, Richard Wolf and many more.

Today the MATACHANA GROUP has an installed base of hundreds of equipment in Oriental Asia, performing thousands of cycles a day. Furthermore, it conducts sev-eral studies in different hospitals all over the region of Asia Pacific in collaboration with opinion leaders from reference hospitals in Beijing, Shanghai, Chengdu, To-kyo and Sydney.


THE CASE OF JAPAN

In Japan, 30% of the medical devices in the CSSD are sterilized in a low temperature sterilizer. This percent-age is 3 times higher than in the majority of European countries and traditionally the technologies chosen were either ethylene oxide (ETO) or Plasma sterilization. Due to strict work, health and safety regulations under the Japanese government enforced on ETO steriliza-tion, the users looked for an alternative, and LTSF has become an option due to the specific standards, stating a good policy that brings safety to the equipment, the process and the usage.

The first MATACHANA 130LF introduced in Japan

was in 2004 by UDONO limited. Due to JIS standards (Japanese Industrial Standards), LTSF sterilization was considered at that time as a disinfector, but the adoption of the ISO 25424 and the EN 14180 by the Japanese authorities in 2005, made the 130LF to become an alternative in Japan. In 2016, the MATACHANA 130LF became the first option for LTSF sterilization in Japan and keeps on growing.

Dr. Kubota of Medical Hospital, Tokyo Medical and Dental University (TMDU), decided to install a 130LF to replace a ETO sterilizer in 2015. “There are 5 autoclaves in our hospital, so we chose to go for a

sterilizer to focus on LTSF sterilization only and not a combined machine. The second reason is that over 95% of ETO sterilized good can be also sterilized to LTSF”, he said.

During the JSMI 2016 (Japanese Society of Medical Instrumentation), Dr. Kubota presented his study on LTSF sterilization safety. The study was focus on the residues of formaldehyde in the wrapping materials and working area.

“Microbicidal efficacy and penetration ability were already studied, so my interest was to check the safety aspects of the LTSF sterilizer. So, I focused on the sterilant residues. The results were satisfactory and I concluded that the 130LF is much safer than ETO sterilizer.

When we installed the LTSF sterilizer in our hospital, the first thing to do was an objective assessment of the real need for sterilization of heat sensitive materials, to avoid high costs of consumables, and second was to conduct a material compatibility study with each medical device in the CSSD to decide in which tech-nology we should do the reprocessing. We achieve excellent results and we managed to reduce the use of the low temperature sterilizer to 10%, reducing costs and time.

So far I am very satisfied with the replacement of our old ETO sterilizer to the Matachana 130LF. I am look-ing forward for further developments on the 130LF to reduce its cycle time, as I really think it is a very good technology for the Japanese hospitals”, he said.

Currently Dr. Kubota is conducting tests based on EN 868 on the sterilization of sterile containers in LTSF. He will submit the results during the JSMI con-gress in Yokohama in 2018. Dr. Kubota is member of the board of the JSMI and he is also the vice-chair-man of the “Metropolitan Sterilization Society".

From left to right: Kaori Tadaki, Yoko Futaba and Dr. Hideo Kubota

Dr. Hideo Kubota - Assistant Professor Materials Management - Tokyo Medical and Dental University


Complete range of MATACHANA cleaning & disinfecting equipment: under counter washers, compact washers including top performance equipment for sterilization centralsCapacity up to 18 DIN baskets per cycleHigh Speed washers: very short cycle timesEnvironmental efficiency: minimum water, energy and detergent consumptionCompact, ergonomic and robust designAutomatic systems with automatic load detectionWashing cabinets for sterile transport trolleys, containers and surgical instrumentsUltrasonic washing equipmentSuper reduced footprint and front access for service

MAT LD

THE EVOLUTION

new matachana washing line

new matachana washing line

www.matachana.com

NEW RUMEDTO SERVICETHE 4 HOSPITALSCOMPLEJO HOSPITALARIO UNIVERSITARIO DE OF A CORUÑA (CHUAC)

The Gerencia de Gestión Integrada in A Coruña (Administration of Intregrated Management), which belongs to the Galician Healthcare

Service, manages all primary, specialized and socio-sanitary care services across the province of A Coruña. The province is formed of 36 municipalities, covering an area of 2,754 Km2, with a distance of 160 Km between the most equidistant point. It is home to 548,794 inhabitants, with a population density of 199 people per Km2, and an aging index of 23.54%.

Among other resources, it has 76 Health Centers, a district hospital, the Hospital Virxen da Xunqueira, and the Complejo Hospitalario Universitario de A Coruña (CHUAC), which is formed of 4 public hospitals corres-ponding with the Servizo Galego de Saúde (SERGAS), with a total of 1422 beds and 33 operating rooms. The Hospital Unviversitario de A Coruña (HUAC) is a tertiary hospital, and serves as a referral hospital for the whole

of A Coruña and the Galician community, for different medical specialties.

Within the framework of the MASTER PLAN of the CHUAC, aimed at transforming the Complex in 2017, the SERGAS awarded a contract to Antonio Matachana S.A. to build the new RUMED (Reprocessing Unit for Medical Devices), with the capacity to serve all its centers, in particular the CHUAC, with a total of 40,000 surgical procedures per year.

The new RUMED covers a total area of 700m2, spread across 3 areas of material reprocessing (dirty, clean and sterile). These areas are separated by corresponding barriers of biological containment, 3 technical compartments (water treatment, air treatment and a centralized detergent dosing service), a compartment for reprocessing flexible endoscopes and a service area with the following equipment:

ENRIQUE GONZÁLEZ RODRÍGUEZDirector of NursingADMINISTRATION OF INTEGRATED MANAGEMENT IN A CORUÑA


The improvements of the new sterilization central include:

• The centralization of all washing, disinfection and sterilization services into a single, fully professionalized unit.

• The forward movement principle: The RUMED is designed so that all medical equipment and transport trolleys have a single movement circuit, without the possibility of going backwards.

• The classification of clean rooms: with the provision of separate air treatment units with absolute filters and ISO 7 classification.

• Environmental sustainability: the equipment is designed and built to fully minimize the environmental impact.

• The centralization and implementation of a single integrated traceability service.

• Face the challenge of opening a new RUMED, which is why we are counting on the collaboration with our project partner and the commitment of our team of professionals. All of this meant that we trained the staff on handling the new equipment, occupational safety and basic patient safety aspects.

Equipment:

Automatic and manual washing area• 2 x Washing tunnels with a double door

and a chamber volume of 5,500 l• 3 x Thermo-disinfectant washers with

a double chamber, and a robotized loading and unloading system.

• 2 x Flexible endoscope washers with a double door

• 3 x Ergonomic washing stations • 1 x Ultrasound washing station • 1 x Manual endoscope washing station

Preparation Area• 8 x Ergonomic workstations

3 x Sealing stations• 5 x Sterilizers with a capacity of 8 TSUs

with a semi-automated loading system

Sterile storage area• 1 x Automatic sterilizer unloading system, • 60 x Transport trolleys and storage

systems.

Ultimately, all of these improvements implicitly led to a transformation in our organization; in the way the RUMED works and in how clients use it, including surgical wings and other hospital units; the added value of continuous training; the promotion and improvement of safety culture among our professionals; and the implementation of safer practices for our patients and fellow citizens.


Developing a new way to open body cavities will constitute a revolution

in modern surgery. In the 1980s, laparoscopy managed to change the classic procedural method that had been used by surgeons for years. Now, natural orifice transluminal endoscopic surgery (NOTES), microlaparoscopy assisted natural orifice surgery (MANOS), single incision laparoscopic surgery (SILS) and other innovative procedures are the paradigm of surgical operations in the 21st century. These techniques started being developed in the late 1990s, but had not yet been sufficiently developed. The objective of NOTES, MANOS and SILS, designed by surgeons and endoscopists over the past ten years, is to work towards an increasingly invisible surgery, not only to preserve cosmesis, but also to make it less invasive, with a reduced risk of infection for patients and a faster recovery. The future of endoscopic platforms and the fusion between laparoscopic instruments and flexible devices, along with robotic surgery, will be a significant step towards ‘scarless’ surgery.

Among the new instruments and equipment being used at an experimental level, those that are particularly appealing are endoscopes, platforms for NOTES and minirobots. What new endoscopes have in common is the development of multiple working channels, up to 4, with the intent to be able to introduce 2 instruments at the same time, and at least 1 other channel to implement coagulation, cleaning and suction. These new endoscopes enable joint working tools, achieving the highly important triangulation, even in a very limited space. These new miniaturized terminals for bipolar coagulation, tissue sealing, ultrasound and radiofrequency seem to be promising elements for facilitating dissection, hemostasis and sealing. Possible energy sources for future application, such as lasers and microwaves, can also find their place thanks to flexible endoscopes.

Elsewhere, the resolution of flexible endoscopes has significantly improved, and are now able to provide images in full HD. However, the classic concept of a long tube should be replaced by a transluminal surgery platform that overcomes navigation difficulties by stabilizing the instrument holder, and allows for a greater capacity of movements, thus enabling more precise triangulation. In spite of this, surgeons that are now using combined flexible endoscopy are facing the same challenges that we had 10 years ago:

• Difficulty in handling the endoscope during surgery due to its dimensions. 2 people are needed.

• The clear need to sterilize the endoscope, given that we are working in cavities and sterile environments (operating room).

• Due to the structural complexity of these devices, we need to use high penetration sterilization technologies, such as Low Temperature Steam with Formaldehyde and Ethylene Oxide.

• These are very unique elements, and are scarce in hospitals due to their high price and constant rotation.

• They have very sensitive internal parts, and must therefore be handled very carefully, including when they are sent to sterilization centrals and returned to the operating room.

• The user, whether that be the surgeon or the person reprocessing these devices, must have a correct understanding and awareness of the type of device, its inspection and maintenance.

While all of these developments have reached our daily practices, we need to promote the combined use of minimally invasive techniques available, and foster collaboration as a team, both at the level of surgeons and in terms of cooperation across the industry. This way, we will establish a fast way to exchange information and transfer new provisions that accelerate the evolution of these flexible platforms, and thus achieve the long-awaited invisible surgery.

INVISIBLESURGERYTOWARDS THE ROBOTICS OF FLEXIBLE ENDOSCOPY PLATFORMS

DR. JOSÉ F. NOGUERAChief of the General Surgery and Digestive System ServiceCHUAC - Complejo Hospitalario Universitario de A Coruña


In Alva-tech sarl, we have always tried to be at the forefront of medical device validation. In recent years, endoscopy has provided us with an innovative

field in terms of the quality and results of procedures.

Observing the progression of validations in Europe (France, Spain, Germany, Italy, Switzerland, etc.), we now find ourselves in a new, complex arena, with very limited references and statistics in these procedures.

Over the past three years, a validation plan for washer disinfectors and endoscope cabinets has been defined and detailed, in close collaboration with BIOTECH-GERMANDE, a European leader in laboratory analyses and tests.

The plan establishes a documented program that provides the security required to demonstrate that the endoscopy units meet the pre-determined specifications. An endoscopy audit takes place, with a view to identify all situations that represent a potential risk of infection.

Our presence in all validation phases and routine endoscope checks provides the level of quality needed in the complex handling of flexible endoscopes, issuing a comprehensive report of the process validation that certifies the effectiveness of the equipment. These reports are consistent with standards and directives in force:

• UNE-EN ISO 15883-1:2009: Washer disinfectors. Part 1: General requirements, terms and definitions and tests.

• UNE-EN ISO 15883-4:2009: Washer disinfectors. Part 4: Requirements and tests for washer disinfectors employing chemical disinfection for thermolabile endo-scopes.

• French Directive: DGOS/PF2/DGS/VSS1/2016/220

Let us advance and continue with the momentum of innovation... There is still a lot to do, and we are the professionals present to assist the Health Centers.

JORGE ÁLVARO Director Alva-tech sarl

PROCESS VALIDATIONIN THE AUTOMATIC WASHERS OF FLEXIBLE ENDOSCOPES AND STORAGE CABINETS


AHMED MENEKBISales Manager North Africa & Middle EastMATACHANA

After the installation of the two large RUMED in 2015 in the Red Cross and Maternity hospitals in Ashgabat, the capital of Turkmenistan, MATACHANA has seen great success in this country, one of the most advanced in Central Asia.

At the end of 2016, after a long public bidding process, MATACHANA’s exclusive distributor in Turkmenistan, MED CONCEPT, was awarded the project to equip the two new hospitals in ‘marble city’, Ashgabat. By bringing both centers together, this has created the most modern and important hospital complex in Turkmenistan: The Endocrinology Hospital (120 beds) and the Surgery Hospital (180 beds).

The tender included all phases related to design, construction works, installations, training and commissioning the healthcare equipment in both hospitals. MATACHANA participated right from the initial design phase of both RUMED, and in the project for the biomedical waste treatment centers, the mattress disinfection center and the morgue.

These RUMED will serve 14 operating rooms in the Surgery Hospital and 4 operating rooms in the Endocrinology Hospital.

As experts in integral solutions, MATACHANA designed a sterilization central in accordance with the

TURKMENISTANANOTHER GREAT SUCCESS IN CENTRAL ASIA



latest standards and recommendations, and with the incorporation of the latest technologies. Both RUMED have 3 work areas that are well separated by physical barriers, achieved thanks the thermo-disinfectant washers and a line of steam and low temperature sterilizers, all of which use a double-door system.

The Surgery Hospital’s RUMED has large manual washing areas, with ergonomic stations that have been specially designed for the pre-cleaning of instruments. One of these stations has an inverse suction ultrasound irrigator for cannulated material.

The surgical material is reprocessed a posteriori in three high-capacity MAT 521XLS washers, which guarantee a high disinfection and drying of materials.

A manual pre-cleaning area has been established for handling flexible endoscopes, consisting in a washing station with ergonomic vats, which have an automatic reprocessor with a capacity for 2 endoscopes. Finally, this area has a double-door cabinet for storing, drying and transferring the endoscopes to the preparation and inspection area.

This area has been equipped with the following: 3 heat sealers, several packaging stations, additional shelves and furnishings to support instruments.

The sterilization area was designed as a versatile line of various technologies, which coexist according to the hospital’s productivity requirements, and depending on the nature of the materials that need to be sterilized. For this reason, there are steam sterilization units and 2 Low Temperature systems: LTSF (low temperature steam formaldehyde) and HPO (hydrogen peroxide & plasma). This way, the hospital can ensure the sterilization of all heat-sensitive materials, according to the urgency/speed of the required process.

Equipment: 3 S1012 model sterilizers (892 liters), 3 130LF sterilizers, 2 130HPO® units and several shelves

for sterile storage, with hermetic trolleys for delivering sterile materials to different operating rooms.

Finally, the quality of supplies for all of these devices is guaranteed by a water treatment system, consisting in reverse osmosis and a water softening device, calculated for the volume of liters used by all of these machines. This equipment is located in the technical room, external to the RUMED.

In summary:

- The Surgery Hospital is the best example of a good partnership between MATACHANA and its distributor in the area, MED CONCEPT.

- This is one of the leading references in Turkmenistan, and the RUMED is the most important in the country, due to the type of equipment, its design and the complexity of its installation, carried out by the MED CONCEPT technical team with the collaboration of MATACHANA.

At MATACHANA, we hope that the efforts of all parties, the Ministry of Health in Turkmenistan, MED CONCEPT and MATACHANA, have reached the expectations for increasing the quality of healthcare services in the country.

Surgery Hospital• 180 beds• 14 operating rooms• Specialities: general surgery, laparoscopy,

urology, thoracic surgery, plastic surgery

Endocrinology Hospital • 120 beds• 4 operating rooms• Specialities: endocrine surgery, thyroid surgery

When the Fundación Althaia de Manresa started a cooperation project with the Hôpital Saint Jean de Dieu de Thiès

(Senegal) in late 2013, we knew we faced a difficult challenge. Our objective was to introduce technological improvements and move towards greater medical and nursing specialization.

IN ORDER TO DEVELOP THIS PROJECT, THE PRIORITY WAS TO HAVE A SAFER AND MORE EFFICIENT SURGICAL WING, AND TO CREATE A STERILIZATION CENTRAL THAT WAS ABLE TO RESPOND TO THE NEEDS OF ALL THE HOSPITAL’S SERVICES.

For this reason, we needed to invest in reforming the infrastructure of operating rooms, creating proper circuits for materials, staff and patients in the surgical area. The initial situation was the existence of two operating rooms; the new one and the old one. There was no communication between the two, and just one room for processing materials and a dry heat oven (Poupinel) to sterilize instruments. These reforms could be carried out thanks to the collaboration of an architect who drew up the plans, donations from various entities and a grant from the Senegalese Ministry of Health.

The works for building the new sterilization central were carried out at the same time as the surgery wing renovations. It now has an area for receiving and washing dirty materials, a clean area for preparation and sterilization, and finally a closed sterile storage area.

Once the works were finished, how could we raise more funds to equip the sterilization central with an autoclave and the furnishings needed? Once again, we carried out a whole host of activities: charity markets, and project presentations to companies in the region in search of sponsorship.

FROM THE POUPINELTO THE AUTOCLAVETHE STORY BEHIND THE CREATION OF A STERILIZATION CENTRAL IN THE HÔPITAL SAINT JEAN DE DIEU DE THIÈS (SENEGAL)

With respect to Senegal, she participates in matters regarding the surgical wing and the sterilization central, the purchase and monitoring of materials, communication with department heads at Thiès, and accompanying volunteers and professionals in Senegal who have carried out placements in our hospital.

ROSA ALSEDÀScrub nurse in the sterilization central of the Hospital Sant Joan de Déu, from the Fundación Althaia de Manresa.Member of the cooperation committee of the Fundación Althaia.


One of the requirements prior to purchasing the autoclave was to ensure that there was a technical service in the country to ensure its installation and subsequent maintenance and repairs, as well as to train staff. We contacted MATACHANA, a company that was also present in our Manresa hospital. Thanks to their availability and interest in the project, we began the processes for purchasing the autoclave and installing the sterilization central.

Renovations were necessary. We had to update the electrics to make sure they was safe and protected against voltage fluctuations, and we needed to improve the water installations, by setting up a pump to guarantee pressure, a water softener and a drain that was able to withstand high temperatures.

At the same time, we agreed with the Thiès hospital management that nurse Marie Iphigénie Diedhiou, from the surgical wing, would spend five weeks on a

placement in our Manresa hospital. Thanks to a grant from the Bages University Foundation, she stayed in Manresa in September and October in 2016, when she divided her time between the sterilization service and the surgical wing, so that she could get used to the autoclaves, packaging, handling and caring for instruments, and minimally invasive surgical procedures.

Finally, after all of these efforts and collaborations, in January 2017 the new sterilization central started operating, with a new MATACHANA SC501E-1 autoclave, with a capacity of 252 l, and a smaller, 80 l autoclave, which was a donation from the Hospital de Barcelona.

A magnificent result, and the outcome of the collaboration and commitment of so many people! An exciting first step towards improving the health care provided by the Hôpital Saint Jean de Dieu de Thiès to the whole region.


I n the spring of 2014, a group of friends, all Spanish or thopedic surgeons, decided to create an NGO to provide regular assistance and

teaching in developing countries. The main reason behind it was the need to monitor the long-term progress required by patients in our specialty. Thus, COEM was born, which are the initials of the name of our association in Spanish: "Cirujanos Ortopédicos de España para el Mundo" (Orthopedic Surgeons in Spain for the World).

We got to work. They accepted us, and we registered with the NGO registry of the AECID. We star ted looking for a place, and for the means required to develop our specialty. It took us almost a year to find a suitable place. Finally, we found a hospital run by a religious community of Spanish origin: "Las Siervas de María", in the francophone village of Batseng’la, close to the city of Dschang in West Cameroon. In June 2015, we went to Batseng’la to inspect the hospital and assess whether it matched the conditions needed for our work. We found a hospital called ‘Notre Dame de la Santé’, which had been recently built. It was solid, but with lit tle activity, and a total lack of knowledge and means in our specialty.

We star ted collecting material and human resources to resolve the lack of instruments, motors, osteosynthesis equipment and structural provisions such as surgical lights, X-ray machines, instrument tables, containers for sterilization, as well as bandages, casts, etc, which we needed to work in our specialty. Human resources were simpler to acquire, thanks to many friends in our specialty across various hospitals in the country. To make the daily work compatible with the expeditions, the trips are 8 days long, every 3-4 weeks. The volunteers pay for all of their own expenses. The sisters provide accommodation and meals. The call for volunteers was so successful that we now have a list of more than 130 people, including or thopedists, anesthetists and nurses from various specialties (scrub nurses,

laboratory, hospitalization and radiology staf f, etc.) In a fairly precarious state, but taking the basic instruments with us in our bags, we began our first expedition in September 2015.

Over time, we have received materials from colleagues, from some hospitals, from within the industry, etc., which, despite being discontinued as they are no longer used, are perfectly usable for our work. We have also received structural supplies such as negatoscopes, computers, examination tables, lamps, rehabilitation equipment, etc. All of this is thanks to the generosity of many friends and colleagues who have provided us with these working means. Little by little, filling up our suitcases on each trip, managing to fill a container with donations, etc., we have created a basic structure that allows us to carry out our consultations and surgeries. From one donation, we were able to get an analog X-Ray machine, install an autoclave and set up another X-Ray system in the operating room. Through another donation, we acquired a traction table, which we needed for many of our surgeries.

MATACHANA has been our supplier for all of these large equipment purchases, such as the operating table, the autoclave and the sterile bag sealer.

Many conversations with Carlos Herrero, the Crossborder Project Manager, and online communication with Mario Gerez, from the MATACHANA Technical Service, to set up the autoclave, have turned us into great friends of the company.

We are still immersed in a major task ahead, developing new projects for which we need economic aid, which will help us to complete our activities. The donations received are tax exempt.

Updated information of our work and collaboration information can be found on our website, www.acoem.es

DR. TOMÁS EPELDEGUIFounder of COEM

COEM IN THE HOSPITAL NOTRE DAME DE LA SANTÉDSCHANG - WEST CAMEROONMATACHANA sterilization service collaborator


Viveriums comprise one of the most active parts of research centers. In

2018, the Instituto de Salud Carlos III will launch its new plat form. These installations are equipped with the latest technical and safety advances, with the capac-ity to carry out work in multiple areas, including the containment area for biological agents. This is something that very few research centers have, given that most of them, even the bigger centers, only have specific-pathogen-free areas (SPF) where animals are raised.

The Instituto de Salud Carlos III (ISCIII) is the main Public Research Body (OPI) that funds, man-

ages and executes biomedical research in Spain. It is attached to the Ministry of Economy, Industry and Competitiveness, although it is also integrated into the Min-istry of Health, Social Services and Equality on an operational level. Its main objective is to fos-ter the generation of scientific knowledge in health sciences and drive innovation in health care and illness prevention. To do this, it promotes and coordinates biomedical research and of fers technical-scientific services, in collaboration with other centers in the Spanish System for Sci-ence, Technology and Innovation.

The ISCIII has a variety of organizational structures, including

JOSÉ LEÓN PANIAGUADoctor of Architecture in the National Microbiology CenterInstituto de Salud Carlos III - Majadahonda

INSTITUTO DE SALUD CARLOS III OPENS ITS NEW RESEARCH CENTER

Mª DEL PILAR PALLARÉS GARCÍAHead of the Veterinary Unit in the Scientific and Technical Central UnitsInstituto de Salud Carlos III - Majadahonda

IN 2018, THE ISCIII, THE LEADING RESEARCH BODY, WILL HAVE LATEST-GENERATION FACILITIES WHERE IT WILL BE POSSIBLE TO WORK WITH BIOLOGICAL AGENTS IN CONTAINMENT AREAS.

DUE TO ITS CHARACTERISTICS AND DIMENSIONS, THE ANIMAL FACILITY’S NEW PLATFORM WILL ALLOW FOR THE INCREASE AND DIVERSIFICATION OF RESEARCH PROJECTS DEVELOPED BY TH INSTITUTO DE SALUD CARLOS III.


the General Sub-Directorate for Applied Services, Training and Research (SGASAFI), a structure that integrates the Veterinary Unit of the ISCIII in Majadahonda-Madrid (UV), responsible for its proper functioning. The main function of the UV, among others, is to guarantee the provision of all the tools needed to develop projects that require the use of animals, and that both their treatment and handling, as well as the installations, are adapted to legislation in force.

In the ISCIII, the need for these platforms is related with two areas: research to be carried out for the various projects of any discipline included in healthcare, and services related to public health offered by the ISCIII, as a leading center and part of the RE-LAB (Biological Alert Laboratory Network).

To achieve this goal, the animal laboratory of the UV works in various areas, from human botulism tests with samples from across Spain, to Leishmania spp or Triquina spp strain maintenance, along with can-

cer trials, immunology, virology, rare illnesses, disease in children, tuber-culosis and AIDS, which make it a multidisciplinary facility with many years of experience.

With a view to strengthen, improve this support and respond to the sci-entific-technological demand, plans were made in 2014 to renovate and expand the animal facilities.

The new building, designed exclusively for rodents, clearly differ-entiates the various work areas: the SPF Area (Specific Pathogen Free) to accommodate mice offspring, more than 90% of which are genetically modified, and the Experimental Breeding Area, to study reproduc-tive pathologies or experiments at young ages. The objective of these two areas is to breed and maintain germ-free mice.

On the other hand, the Exper-imental Area is designed with a biosafety level of BSL2 and BSL3, for working with viruses, bacte-ria, parasites and fungal growth in humans.

Finally, the Quarantine Area with laboratories, designed for handling

embryos, the stage at which they will be taken to the breeding and SPF zones through rederivation, ensur-ing the maintenance of SPF status.

Additionally, within the High-Se-curity Level 3 laboratory, an Experimental Area of the same bio-logical containment level, BSL3, has been set up for rodents.


To achieve a degree of protection and the con-tainment of experimental

biological agents, there are auto-claves, an SAS (Safety Airlock System) and sterile air showers distributed strategically through-out the facility. This means that materials enter the facility germ-free, and both staff and animals enter the installation in a con-trolled way, reducing the risk of contamination. Likewise, in the BSL2 and BSL3 areas, these devices can monitor experimen-tal germs and contain them in the work area.

This new facility has been designed with innovative equip-ment in the field of automatic and semi-automatic washing and

sterilization, attempting to make the worker’s tasks easier and limit contact with allergens of animal origin, reducing occupational illnesses in this sector.

The new installation is located in the new building, with direct access from the outside. Its upper level, dedicated to the technical plant, has an area with the same dimensions, with a dif ferent point of access for maintenance, where the air conditioning equipment is located, along with specific instal-lations of the animal facility.

Each of the areas integrated into the new vivarium has dif ferent access points. The washing area, which works as a barrier between the other areas (SPF, breeding,

experimentation and quarantine) has natural light, so that the work-ers have environmental conditions that allow them to orient them-selves throughout the working day. This barrier is formed by the autoclaves, SAS and rack washing equipment.

The equipment’s level of auto-mation is in relation to the size of the new animal facility. Due to its characteristics and dimensions, the new platform will allow for the increase and diversification of research projects developed by the Instituto de Salud Carlos III.

RISK REDUCTION


CEFHJournées nationales d’études sur la stérilisationThe congress took place on 29 and 30 June 2017 in Lyon, France. MATACHANA showcased its new products.

AALASAmerican Association for Laboratory Animal Science The congress took place from October 15-19th 2017 in Austin, USA. MATACHANA USA participated again in this event, presenting its new line of steam sterilizers. A major success was achieved, both with the event; as a large number of visitors attending our stand, and with the dinner organized for the clients and partners.

ARAB HEALTHDubai International Convention & Exhibition CentreWas held from 30 January to 2 February 2017 in Dubai, UAE. In this image we can see the stand with which MATACHANA attended.

WFHSS Took place from 4 to 7 October 2017 in Bonn, Germany, presenting its new line of washing MAT LD and new low temperature hydrogen peroxide sterilization equipment. The event made official the unification of the MATACHANA brand for all products and companies within the group.

OUTSTANDING EVENTSIn 2017 MATACHANA participated in more than forty international fairs and congresses. They have shown the latest novelties and integral solutions offered by the company.

FAIRS &CONGRESSES


EXPOQUIMIATook place in Barcelona, from 2 to 6 October.MATACHANA exhibited its equipment and solutions for Life Science and Pharma.

MEDICAWorld Forum for MedicineAs every year MATACHANA participated in MEDICA which was held in Düsseldorf, Germany from 13 to 11 November 2017.MATACHANA presented its new MAT LD washing line and the new low temperature equipment by hydrogen peroxide and plasma.

MONITORING KITS

WASHING KIT ENDOSCOPE KIT

MINICLAVE KIT

SEAL KIT

H2O2/PLASMA KIT LTSF KIT

STEAM KIT

KIT for LIFE SCIENCE applications

Need to refine the routine control of your equipment in your sterilization department?

Do you have it already established and need to secure controls in place for a year?

MATACHANA presents a complete range of process monitoring kits for routine control.

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BluKat®

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User friendly

3 cycles: Rapid, Advanced and StandardLoad release via PCD

BluKat® sterilizing solution

Device concept and process environmentally sustainable

MATACHANA own range of monitoring devices

Easy & quick installation (plug & play)

INNOVATINGHEALTHCARE

130HPO® / 50HPO®

LOW TEMPERATURESTERILIZERSBY HYDROGEN PEROXIDE & PLASMA

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