Can a hydrophilic guidewire be resterilized?

Abstract

The Glidewire (Microvasive, Natick, MA) or Terumo wire (Terumo, Japan) is constructed with a hydrophilic polymer surface that enables easier passage through narrowed lumens in the urinary tract. This study examined the effects of gas sterilization on Glidewire surface structure, slipperiness, and ability to support bacterial growth. Light microscopy at 100x and 400x and scanning electron microscopy at 100 to 1300x were used to compare the surface tips of five new 0.038-inch Glidewires with those resterilized one or three times. The tips were immersed in water prior to standard gas sterilization for operating room equipment. Subjective evaluation of slipperiness involved asking 10 blinded urologists to assess the nature of new and resterilized wires by feel. Support of bacterial growth was assessed by comparing cultures performed on new wires (control) with those of wires incubated with Bacillus stearothermophilus. Microscopy, reviewed by a pathologist, revealed no perceivable surface differences after one and three gas sterilizations. Eight of the urologists noted similar or improved slipperiness of resterilized wires compared with new wires. Bacterial cultures of intentionally infected wire segments showed no growth after standard gas sterilization in all cases. In this study, gas sterilization did not adversely affect the lubricious nature or the surface coating of the hydrophilic coating of Glidewires. Also, gas resterilization was bactericidal to new and used wires that had been infected with a heat-tolerant organism.