Usefulness of ozonated water for shunt washing

Abstract

This prospective crossover study aimed to evaluate the efficacy of ozonated water for shunt washing, compared with invert soap and alcohol. Seventeen hemodialysis (HD) patients were enrolled. We assessed transient cleanliness levels, based on the levels of ATP＋ADP＋AMP, during HD (before washing; at the start of the HD; and at 2 hr, 4 hr, and 6 hr after the start of the HD) in patients that were washed with ozonated water, invert soap, or alcohol. Moreover, to study shunt limb roughening we graded the shunt limbs after each washing method (grades 1 to 5; 1: not rough, 5: severely rough). In each group, the ATP＋ADP＋AMP level was significantly decreased after washing (ozonated water group: 2,816 to 515 RLU, p=0.0354; invert soap group: 2,140 to 306 RLU, p=0.0414; alcohol group: 2,924 to 431 RLU, p=0.0113), and the final RLU value was below the hand hygiene management standard (2,000 RLU). The scores for the degree of shunt limb roughening were 1.06±0.24, 1.24±0.44, and 1.41±0.50 in the ozonated water, invert soap, and alcohol group, respectively. The ozonated water group exhibited significantly less shunt limb roughening than the alcohol group (p=0.0411). Washing shunt limbs with ozonated water is as effective as washing them with soap or alcohol throughout HD. From the viewpoint of skin care, ozonated water is an invaluable substance for cleaning shunt limbs.