Since the inception of flexible fiberoptic endoscopes, disinfection of these instruments has been a problem. Soaking in glutaraldehyde does not always achieve sterilization, and often damages the scopes. Ethylene oxide can sterilize endoscopes; however, it is economically impractical because of a required downtime of 24 hours. Thus, it is obvious, especially with respect to human immunodeficiency virus, hepatitis B virus, and Mycobacterium, that a new technique to attain sterility is necessary. This paper discusses a new method of sterile introduction of the flexible nasopharyngolaryngoscope. The technique employs disposable sterile sheaths that are prepackaged and made from a thermoplastic elastomer with a clear optical end. The sheaths can be applied in seconds and tightly adhere to the flexible insertion portion of the scope. Results to date indicate that the performance of the endoscope is unhindered by using the sheaths. Furthermore, there has been no break in the integrity of the sheaths or damage to instruments. It is our opinion that these devices will greatly improve the level of sterility while at the same time reducing costs and downtime.
Clinical Outcomes during Treatment Interruptions in Human Immunodeficiency Virus–Hepatitis B Virus Co-infected Patients from Sub-Saharan Africa
