Luminal Visualization versus White Swab Detection for Residual Contamination: A Single-Center Study at a Chinese Tertiary Hospital.

BACKGROUND: Residual contaminants in lumen-type medical devices pose infection risks. Conventional white swab detection has a limited detection rate, underscoring the need for a cost-effective on-site screening tool. METHODS: In a single-center, prospective comparative study (Feb-May 2025), 1,100 cleaned orthopedic devices (500 intramedullary nails, 100 flexible bone drills, 500 others) were evaluated pre- and post-cleaning using a luminal visualization system and white swab detection. Outcomes included positive detection rates, time per item, material cost, and contaminant removal rate. RESULTS: Pre-cleaning, positive rates were 63.5% (698/1,100) for visualization vs. 18.9% (208/1,100) for swabs; post-cleaning, 35.2% (387/1,100) vs. 8.5% (94/1,100) (P<0.05). Median detection times were comparable (visualization: 34 s, IQR 20.0-44.0; swab: 32 s, IQR 16.0-38.0). Material cost was significantly lower for visualization (median 1.0 yuan, IQR 0.8-1.0) than for swabs (20.0 yuan, IQR 20.0-20.0) (P<0.05). Overall contaminant removal rate by visualization was 44.6%, highest for nails (68.1%) and lowest for drills (2.0%). CONCLUSION: Luminal visualization offers superior detection rates and significantly lower cost versus white swab detection, supporting its use for on-site screening of lumen device cleaning quality.