APPLICATION OF ELECTROCHEMICALLY ACTIVATED SOLUTIONS IN THE TRAUMA AND ORTHOPEDIC CLINIC

V. М. Мelnikova, N. V. Loktionova, А. S. Samkov, G. G. Оkropiridze, G. P. Belikov, V. М. Bakhir, О. I. Sukhova, S. А. Panicheva

N. N. Priorov Central Institute of Traumatology and Orthopedics (CITO)

NPO EKRAN, Moscow State Medical and Stomatological University.

For several years, CITO clinical departments and laboratories have been using electrochemically activated solutions for disinfection and sterilization. These solutions are synthesized by the device STEL-10H-120-1 (catalytic neutral anolyte). The results obtained are promising for the prevention of nosocomial infections. Practically, no other disinfectants are used at the hospital.

 

Nosocomial infections in surgical hospitals are recognized to be a serious medical, social and ecological issue [12, 13]. In this connection, of huge importance is the employment in such hospitals of present-day efficient disinfectants. Electrochemically activated solutions certainly belong to such disinfectants.

The term “electrochemical activation” was introduced in 1974. In 1981-1985 more than 100 designs of devices for producing electrochemically activated solutions were known. A lot of amateurish devices appeared producing “live” and “dead” water, but they were not founded on any serious scientific basis. Substantiation of electrochemical activation was given in the works of V. M. Bakhir [1, 2]. The main designer of STEL devices meant for producing electrochemically activated solutions (anolyte, catholyte) is NPO EKRAN [3,8].

Electrochemical activation takes place when 10% sodium chloride aqueous solution is treated in the electrochemical reactor. As a result of transforming substances contained in this solution, highly effective solutions of acids and oxidants (anolyte) as well as alkali and reductants (catholyte) are produced. Anolyte demonstrates a highly antibacterial, anti-viral and anti-fungal efficiency, and catholyte – washing properties [13, 15]. The first appliances for producing disinfectant, sterilizing and washing solutions were STEL -МТ-1 devices [3]. Today there exist over 50 STEL modifications.

In 1992 CITO started testing STEL-4Н-60-01 and STEL-10АК-120-01 devices. A program of testing solutions synthesized by these devices, which included studying anolyte (acid and neutral) antibacterial ability and application of anolyte and catholyte in some of the institute’s structures to clean premises and disinfect equipment. At present, the institute is equipped with last generation STEL -10Н-120-01 devices. The table given below shows efficiency parameters of ANK anolyte produced with the help of the devices in question concerning nosocomial microorganism strains isolated from patients’ septic wounds.

It is essential that STEL-10Н-120-01 devices are installed in CITO’s disinfection and sterilization department. The four-year experience proves that all the institute’s requirements for daily and general indoor cleaning, disinfection of equipment, dressing material, laboratory glass- and tableware, are fully satisfied with only 0.05% ANK neutral anolyte produced with the help of new devices. According to calculations the daily need for ANK neutral anolyte is up to 2000 liters [10]. In recent years, the Institute practically has not required any other disinfectants. The CITO microbiological laboratory regularly checks ANK antibacterial ability as regards nosocomial microorganism strains.

 

Antimicrobial efficiency of neutral anolyte (ANK) produced by STEL-10Н-120-0 device in respect of clinical microorganism strains in tests in vitro

Microorganisms	Solution concentration												Control (saline solution)
	0.01%				0.03%				0.05%
	5	15	30	>30	5	15	30	>30	5	15	30	>30	5	15	30	>30
Aerobes:
S.aureus	+	-	-	-	+	-	-	-	+	-	-	-	+	+	+	+
S.epidermidis	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Streptococcus spp.	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Enterococcus spp.	+	+	-	-	+	+	-	-	+	+	-	-	+	+	+	+
Ps.aerugenosa	+	+	-	-	+	+	-	-	+	+	-	-	+	+	+	+
Klebsiella spp.	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Proteus spp.	+	-	-	-	+	-	-	-	+	-	-	-	+	+	+	+
Bac.subtilis	+	+	-	-	+	+	-	-	+	+	-	-	+	+	+	+
Anaerobes:
Peptococcus spp.	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Peptostreptococcus spp.	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Eubacterium spp.	-	-	-	-	-	-	-	-	-	-	-	-	+	+	+	+
Clostridium spp.	+	+	-	-	+	+	-	-	+	+	-	-	+	+	+	+
Symbols: “+” – growth, “-” – no growth.

 

Calculations performed by NPO EKRAN professionals show that a 6 hours per day operation of one STEL-10Н-120-01 device (model 80-01) secures economic effect for medical and prevention facilities ranging between 200 and 200 thousand rubles (US $ 8-12 thousands) a year (as compared to previously employed disinfectant means).

Equipping CITO with STEL-10Н-120-01 devices providing convenience and continuous supply of disinfectant solution allows:

• constantly having adequate amounts of efficient disinfectant solution in the Institute’s departments:
• controlling solution discharge and demand for it in the clinical units and laboratories, regularity and appropriateness of its application and, as a consequence, raising the quality of daily and general cleaning of the departments;
• deriving considerable economic benefits.

From the standpoint of nosocomial infections, the most vulnerable units requiring permanent bacteriological control are surgical units, dressing rooms, resuscitation and intensive care unit, all children’s departments, osteo-pathology and joint endoprosthesis departments: the unit of septic complications stands out, because it may become a source of infection unless all sanitary and hygienic rules are observed in the most precise manner, and regular thorough disinfection of the environment and equipment is performed. The results of bacteriological control in these departments in 1999-2000 were quite favorable.

In the course of combating nosocomial infections special attention should be paid to treating pyo-inflammatory septic complications, and wound infection. It is known that in recent years microorganism poly-resistance even to new antibiotics has dramatically increased — some experts consider this phenomenon to be ecological disaster. It is evident that to prevent and treat infections today, new chemotherapy preparations should be sought. And so, electrochemically activated solutions attract special attention.

The probability of microorganism adaptation to activated anolyte has been supposed [14] to be negligible. Also, there is evidence that neutral anolyte elevates microorganism sensitivity to antibiotics [4, 18]. No microorganism adaptation to neutral anolyte was observed when it was used for washing septic wounds in maxillo-facial surgery [17]. All these findings are sure to be worth attention and further study.

Experiments on rats were carried out in CITO, using a 0.012% AN neutral anolyte produced by STEL-МТ-1 device, for the prevention and therapy of slash and gunshot wound complications [9], which experiments were very encouraging. As in other authors’ reports [7] it was found that the neutral anolyte is efficient in the first phase of the wound process, and the catholyte – in the second and third phases.

Locally, the electrochemically activated solutions produced by STEL devices were used by some authors for inflamed and trophically disturbed skin sanation, for treating erosive mucous membranes, trophic ulcers, infected wounds, abscesses and burns. The general method is a two-stage local application of solutions – using the anolyte as an antiseptic and the catholyte as a bio-stimulator. ANK neutral anolyte, unlike other antiseptics, is capable of oxidative detoxification [16].

In conclusion it should be noted that the results of multiyear complex work on studying the electrochemically activated solutions and developing methods of their application in surgical (in particular, trauma and orthopedic) hospitals [5, 6, 11, 12] prove the trend’s good prospects in the struggle against nosocomial infections. The electrochemically activated solutions are promising not only as disinfectants, but also as chemotherapeutic means for the prevention and treatment of a number of infections.

References

1. Bakhir V.M., Atadzhanov A.V., Mamadzhanov U.D. et al. //Bulletin of the Uzbek Academy of Sciences, technical sciences series —1981.—N 5.— P. 68-72.
2. Bakhir V.M. Nature and prospects of electrochemical activation. — Moscow, 1989. — P. 89.
3. Bakhir V.M. Electrochemical activation. — Moscow, 1992.—Part 2.—P. 65.
4. Bazhenov L.G., Khadzhibayev A.M. // The First International symposium “Electrochemical activation”: Summaries of papers and brief reports. — Moscow, 1997. —Pp. 124-125.
5. Belikov G.P., Kopeikin V.N., Melnik Z.N. et al. // II All-Russian Conference on Sterilization and Disinfection in Medicine: Summaries of papers. — Moscow, 1993. — Pp. 54-56.
6. Belikov G.P., Loktionova N.V., Melnikova V.M. et al //The Kremlin Medicine. Clinical Bulletin. — 2000. — April-July. — Pp. 79-81.
7. Gryaznukhin E.G., Afinogenov G.Ye. //The Second International Symposium “Electrochemical Activation”: summaries of papers and brief reports. — Moscow, 1999. — Pp. 156-158.
8. Leonov B.I., Prilutsky V.I., Bakhir V.M. Physical and Chemical Aspects of the Biologic Effect of Electrochemically Activated Water. — Moscow. 1999. — P. 243.
9. Loktionova N.V., Melnikova V.M., Shalney A.N. et al. //All-Russian Conference “Electrochemical Activation in Medicine, Agriculture and Industry”: summaries of papers. — Moscow, 1994. —4.2.—Pp. 115-118.
10. Loktionova N.V., Samkov A.S., Sukhova O.I. et al. // First International Symposium “Electrochemical Activation”: summaries of papers and brief reports. —Moscow, 1997.—Pp. 68-69.
11. Melnikova V.M., Belikov G.P., Zarezayev O.A. //The same source.—Pp. 69-70.
12. Melnikova V.M., Belikov G.P., Loktionova N.V. et al. //Conference “Nosocomial infections — the Problems of Epidemiology, Clinical Analysis, Diagnostics and Prevention”: summaries of papers. — Moscow, 1999. — Pp. 152-153.
13. Melnikova V.M., Belikov G.P., Loktionova N.V. et al. //Bulletin of Vinnitsa State Medical University. — 2000. —V. 4, N 2.—Pp. 327-328.
14. Panicheva S.A. New Technologies in Disinfection and Sterilization of Intricately-shaped Medical Articles.—Moscow, 1998.—P. 122.
15. Panteleyeva L.G., Arefyeva L.I., Kiselyova G.A. et al. //All-Russian Conference on Methods and Means of Sterilization and Disinfection in Medicine: summaries of papers. — Moscow. 1992.—Pp. 74-75.
16. Prilutsky V.I., Bakhir V.M. Electrochemicaly Activated Water. Anomalous Properties, Mechanism of Biologic Action. —Moscow. 1997. — P. 228.
17. Tarasenko S.V., Agapov V.S., Lakshin A.M. //Second International Symposium “Electrochemical Activation”: summaries of papers and brief reports. — Moscow. 1999.—Pp. 176-178.
18. Toropkov V.V., Altshul E.B., Peresypkin O.I. //The same source. — Pp. 93-95.

Published in the Bulletin of N.N. Priorov Central Institute of Traumatology and Orthopedics, No.1, 2001.