Connor,T.H, Anderson,R.W., Sessink,P.J et al. (2002). Effectiveness of a closed-system device in containing surface contamination with cyclophosphamide and ifosfamide in an IV admixture area.  American Journal of Health-System Pharmacy 59(1): 68-72.

PhaSeal® a closed-system transfer device was tested at the newly renovated MD Anderson Cancer Center in Houston, TX  and compared with traditional techniques, both in conjunction with their new installed biological safety cabinets (BSC’s) for a total of 168 days. Wipe sampling was done and samples were collected from 18 locations in the pharmacy area before drug preparation resumed. These locations were BSCs, carts, tables, countertops, the transfer window and mats immediately in front of the BSCs, and the floor throughout the preparation area. Every area to be sampled was measured and 20 mL of 0.03 M sodium hydroxide was applied to the location. The location was then wiped with two tissues until dry, and the tissues were placed in coded 175-mL plastic screw-top bottles. Following the wiping, all doses of cyclophosphamide and ifosfamide were prepared using the PhaSeal system. As a control, all doses of fluorouracil were prepared using their traditional standard method (without PhaSeal). After the baseline sampling, the 18 locations were sampled every four weeks for each of the three agents. Sampling continued for a period of 24 weeks, resulting in six post-intervention sampling dates. The results revealed that drug preparation of cyclophosphamide and ifosfamide was contained with the use of PhaSeal and fluorouracil contamination increased for most locations, including the two BSCs and several areas on the floor over the 168 day period in a high-volume IV admixture area. The implications for this study conclude that PhaSeal in conjunction with the use of BSCs in an I.V. admixture area, contained surface contamination resulting from the preparation of cyclophosphamide and ifosfamide; while traditional techniques  in conjunction with the use of BSCs  resulting from the preparation of fluorouracil is insufficient.

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