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a) No.
All centers inserting and/or removing NORPLANT® Implants should follow basic infection prevention measures, including:
- careful aseptic technique (including appropriate handwashing by the provider and thorough cleaning of the insertion site),
- proper decontamination of reusable sharps and other instruments,
- sterilization (or, at a minimum, high-level disinfection) of all equipment, and
- safe disposal of contaminated sharps, and other disposables.
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a) Although insertion and removal of NORPLANT® Implants are minor surgical procedures, careful aseptic technique, including good surgical technique, must be followed to prevent an increase in infections at the insertion site. Infection may result in early removal or spontaneous expulsion of the NORPLANT® Implants capsule.
Another concern is the increasing problem of transmission of hepatitis B and AIDS viruses to clients, health care providers and clinic staff, especially cleaning personnel. To minimize this risk, blood contaminated waste must be properly disposed of, and soiled instruments, gloves and other items must be decontaminated, then thoroughly cleaned and then sterilized or high-level disinfected after every case.
Sterilization (the destruction of all microorganisms, including endospores) is the preferred practice for processing instruments and other items that come in contact with the blood stream or touch tissue beneath the skin. When sterilization is not possible, high-level disinfection (which destroys all microorganisms except some endospores) is acceptable.
Regardless of which method (sterilization or high level disinfection) is used for instruments and other items, thorough cleaning of the client's arm and hand to remove soil and organic material is also necessary to prevent infection. Appropriate dressing and instruction to clients on hygiene of the insertion site are also important.
- Tietjen L, Cronin W, McIntosh N. Infection Prevention for Family Planning Service Programs: A Problem-Solving Reference Manual. Durant, OK, Essential Medical Information Systems, Inc., 1992, pp 152-154.
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