Mark Stibich, PhD
Chief Scientific Officer, Xenex Disinfection Services

In the ongoing efforts toward surgical site infection (SSI) prevention, healthcare facilities are increasingly looking to technological solutions that can significantly enhance standard cleaning protocols. While there are now a bevy of manufacturers offering options for treating surfaces with UV light, the folks at Xenex Disinfection Services are quick to argue that not all solutions are the same.

And the manufacturer has equally committed advocates among their users.  

“At Broward Health Imperial Point, our LightStrike robot is used at the end of day for terminal cleaning of all OR suites (7 total),” says Thomas Kester, RN, MSN, CNOR, the chief nursing officer and chief operating officer of the Fort Lauderdale facility. “Each OR suite is disinfected every day (after the procedures are done), which takes a total of 16 minutes per suite (two eight-minute cycles). As a result, we've seen our SSI rates decrease significantly since we began using pulsed xenon UV."

To find out more about the Xenex LightStrike technology and recent findings on how quickly the LightStrike can make a difference, Surgical Products interviewed Mark Stibich, PhD, the manufacturer’s chief scientific officer.

What can you tell us about the new research that established the effectiveness of the Xenex LightStrike in a notably short amount of time?

Previous studies have demonstrated that contamination builds in the OR during the day, even when manual cleaning is taking place in between procedures. A hospital recently evaluated the efficacy of a shorter run-time for the LightStrike robot in the OR to bring down the bioburden and reduce the risk of surgical site infections. They conducted environmental sampling after running the LightStrike robot for 1, 2 and 10 minutes. There was no statistical difference in the amount of vegetative bacteria left in the OR after the 2 and 10-minute run-times, which led to the conclusion that running a 2-minute cycle at the head of the surgical table in between cases makes between-case cleaning in the OR a viable option and something hospitals should consider operationalizing within their protocol. The doctor who led the study is developing the manuscript now and we are looking forward to its publication.

What specific results have you seen in hospitals that employ the LightStrike?

Nine hospitals using LightStrike robots have reported significant reductions in their infection rates and published their results in peer-reviewed journals, even Clostridium difficile (C.diff), which is very difficult to kill. Lowell General Hospital experienced a 46 percent decrease in SSI rates and Trinity Medical Center had a 100 percent decrease in Class 1 SSIs after using our pulsed xenon UV technology to disinfect their ORs.

In addition the peer-reviewed research, we've had dozens of hospitals tell us about their success in bringing down SSI rates after using LightStrike for room disinfection. Unlike competing technologies, the LightStrike robot turns on instantly with no warm-up or cool-down time, so it can be brought into the OR to quickly disinfect the area around the surgical table in between procedures.

(Image credit: Xenex)

There are now several options out there providing UV disinfection. What’s unique about the Xenex LightStrike?

The Xenex LightStrike robot is the only UV technology that uses pulsed xenon and not mercury bulbs to create UV light. The difference is that pulsed xenon UV is faster and destroys pathogens in a scientifically different way than mercury UV. Our UV light is full spectrum whereas mercury UV devices work only at one spectrum — 253.7 nanometers. Most importantly, hospitals using pulsed xenon UV are reporting significant reductions — 50-100 percent — in infection rates in the peer-reviewed literature. Hospitals considering UV disinfection technology need to carefully evaluate the clinical evidence that the technology is effective in the hospital setting — which means peer-reviewed studies that show how a hospital has experienced a decrease in infection rates after using a UV disinfection system.

Making decisions about new technologies to prevent infections can be challenging, so you must consider the clinical evidence. Hospital decision-makers need to ask tough questions when it comes to evaluating UV technologies. The gold standard for assessing new technologies is evaluating the peer-reviewed literature. Ask the UV vendor to show you peer-reviewed studies from hospitals that saw a reduction in infection rates. If they don't have peer-reviewed and published infection rate reduction studies, then the technology is inadequate and has not met the standard for evidence-based medicine.

What support does Xenex offer to facilities that utilize the LightStrike?

We believe that our customer support and service is unparalleled. We don't just ship a robot to a new customer and hope they figure out where and when to run it. We work with a hospital to determine how many robots they need to meet their infection prevention goals and achieve ROI. Our implementation team trains all the shifts of employees that will be running the robots and then our account management team supervises the hospital's day-to-day robot utilization. We can help them adjust their protocol to address certain issues — a norovirus or Acinetobacter outbreak, for example — and provide additional training when and if necessary.

Anything else you’d like to add?

If your facility is considering UV disinfection, then make sure you are looking at the peer-reviewed literature from hospitals that experienced a decrease in infection rates. Many of the mercury UV vendors will tell you that all UV light is the same and it's not. Pulsed xenon UV is scientifically different than mercury UV and as a result, hospitals using pulsed xenon UV are seeing reductions in their infection rates.

Many hospitals invested in mercury UV technology when it launched a decade ago. A lot has changed since then, and major advancements in UV technology are now available. Hospitals that use mercury UV devices may have experienced materials damage and discoloration of their hospital equipment. As a result of the continuous exposure to UV light caused by mercury disinfection devices, hospital equipment — including plastics and paint — has been shown to yellow or discolor in as little as 90 days. Hospitals can have confidence when using Xenex LightStrike pulsed xenon UV robots because customers have not reported any equipment or materials damage caused by pulsed xenon light exposure after over 5 years of usage.