{"id":48954,"date":"2025-12-04T17:20:07","date_gmt":"2025-12-04T16:20:07","guid":{"rendered":"https:\/\/sssh.ch\/forum\/le-blacking-dans-les-srdm-un-phenomene-rare-mais-a-ne-pas-sous-estimer\/"},"modified":"2025-12-04T17:20:08","modified_gmt":"2025-12-04T16:20:08","slug":"le-blacking-dans-les-srdm-un-phenomene-rare-mais-a-ne-pas-sous-estimer","status":"publish","type":"forum","link":"https:\/\/sssh.ch\/it\/forum\/le-blacking-dans-les-srdm-un-phenomene-rare-mais-a-ne-pas-sous-estimer\/","title":{"rendered":"Le blacking dans les SRDM: un ph\u00e9nom\u00e8ne rare, mais \u00e0 ne pas sous-estimer."},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"48954\" class=\"elementor elementor-48954 elementor-48892\" data-elementor-post-type=\"forum\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6992f06 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6992f06\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-0df7405\" data-id=\"0df7405\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5410735 elementor-widget elementor-widget-image\" data-id=\"5410735\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita-300x300.png\" class=\"attachment-medium size-medium wp-image-48514\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita-300x300.png 300w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita-1024x1024.png 1024w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita-150x150.png 150w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita-768x768.png 768w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/10\/Zita.png 1388w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-737a990\" data-id=\"737a990\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-298403f e-flex e-con-boxed e-con e-parent\" data-id=\"298403f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b8e7e54 elementor-widget elementor-widget-text-editor\" data-id=\"b8e7e54\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4>Portrait express<\/h4>\n<p>Zita Gerhardt est responsable du SRDM de l\u2019H\u00f4pital de Muri (AG), o\u00f9 elle travaille depuis juin 2022. Physicienne de formation, elle est titulaire du cours technique niveau III et est active en st\u00e9rilisation hospitali\u00e8re depuis 2012, exer\u00e7ant une fonction dirigeante depuis 2017. Aujourd\u2019hui, elle est responsable de l\u2019organisation, de l\u2019assurance-qualit\u00e9 et du d\u00e9veloppement du retraitement. Parall\u00e8lement, elle s\u2019engage comme formatrice en entreprise. Depuis septembre 2025, elle est membre du Comit\u00e9 Section Suisse al\u00e9manique de la Soci\u00e9t\u00e9 suisse de St\u00e9rilisation hospitali\u00e8re. Elle \u0153uvre avec \u00e9nergie en faveur de standards qualitatifs \u00e9lev\u00e9s dans le retraitement des dispositifs m\u00e9dicaux, ainsi que du d\u00e9veloppement technique continu de la profession.<\/p>\n<p>Le terme <em>blacking<\/em> d\u00e9signe la formation d\u2019une couche fonc\u00e9e de magn\u00e9tite sur des surfaces m\u00e9talliques, en particulier sur de l\u2019acier inoxydable, \u00e0 la suite de leur traitement \u00e0 la vapeur obtenue \u00e0 partir d\u2019eau d\u00e9min\u00e9ralis\u00e9e, \u00e0 des temp\u00e9ratures sup\u00e9rieures \u00e0 120 \u00b0C.<\/p>\n<p>Au cours des treize ann\u00e9es pass\u00e9es dans un service de retraitement des dispositifs m\u00e9dicaux (SRDM), je n\u2019ai rencontr\u00e9 ce ph\u00e9nom\u00e8ne qu\u2019une seule fois (illustrations 1 et 2). Sur une p\u00e9riode d\u2019environ trois ans, nous avons observ\u00e9 une coloration noire inhabituelle, tant dans des st\u00e9rilisateurs que sur des instruments chirurgicaux. La pr\u00e9sente publication retrace les efforts syst\u00e9matiques entrepris pour en identifier les causes, pr\u00e9sente les conclusions des analyses ainsi que les mesures prises pour rem\u00e9dier au probl\u00e8me. Elle vise \u00e0 sensibiliser le personnel des SRDM au ph\u00e9nom\u00e8ne rare, mais important, du <em>blacking<\/em>.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e51344b e-flex e-con-boxed e-con e-parent\" data-id=\"e51344b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-0b2ae39 e-con-full e-flex e-con e-child\" data-id=\"0b2ae39\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5ca2354 elementor-widget elementor-widget-image\" data-id=\"5ca2354\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"449\" height=\"275\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita1.jpg\" class=\"attachment-large size-large wp-image-48930\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita1.jpg 449w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita1-300x184.jpg 300w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 1 : blacking sur les parois de la chambre d\u2019un st\u00e9rilisateur.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-14a2fd1 e-con-full e-flex e-con e-child\" data-id=\"14a2fd1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d229dcc elementor-widget elementor-widget-image\" data-id=\"d229dcc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"650\" height=\"394\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita2.png\" class=\"attachment-large size-large wp-image-48931\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita2.png 650w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita2-300x182.png 300w\" sizes=\"(max-width: 650px) 100vw, 650px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 2 : blacking sur des instruments chirurgicaux.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6e26ff5 e-flex e-con-boxed e-con e-parent\" data-id=\"6e26ff5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d480eaf elementor-widget elementor-widget-text-editor\" data-id=\"d480eaf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4>Situation initiale<\/h4>\n<p>Le ph\u00e9nom\u00e8ne observ\u00e9, c\u2019est-\u00e0-dire la coloration noire de certaines surfaces (dans le jargon, on parle de <em>blacking<\/em>), s\u2019est r\u00e9v\u00e9l\u00e9 \u00eatre le r\u00e9sultat d\u2019une interaction complexe entre diff\u00e9rents facteurs. Pour en d\u00e9terminer les causes, toutes les \u00e9tapes de proc\u00e9d\u00e9s ont \u00e9t\u00e9 contr\u00f4l\u00e9es individuellement et en parall\u00e8le, afin de pouvoir exclure ou d\u00e9limiter les \u00e9ventuelles sources d\u2019erreurs. Il s\u2019agissait d\u2019identifier de mani\u00e8re univoque l\u2019origine du probl\u00e8me, ainsi que d\u2019\u00e9liminer durablement les colorations et d\u2019emp\u00eacher qu\u2019elles ne se reforment \u00e0 l\u2019avenir.<\/p>\n<h4>Acier inoxydable et couche passive [1]<\/h4>\n<p>Les st\u00e9rilisateurs et les instruments chirurgicaux sont en r\u00e8gle g\u00e9n\u00e9rale compos\u00e9s d\u2019acier inox(ydable)<strong>.<\/strong> La grande diff\u00e9rence entre l\u2019acier inox et l\u2019acier ordinaire r\u00e9side dans leur teneur en chrome\u00a0: en effet, si l\u2019on adjoint au minimum <strong>10,5 % de chrome<\/strong> \u00e0 de l\u2019acier ordinaire<strong>, <\/strong>une fine couche invisible d\u2019oxyde de chrome se forme sur les surfaces\u00a0; on parle alors de couche passive.<\/p>\n<p>Cette couche prot\u00e8ge le m\u00e9tal de la corrosion, de la salet\u00e9 et des influences chimiques. En conditions normales, et en pr\u00e9sence de suffisamment d\u2019oxyg\u00e8ne, elle se r\u00e9g\u00e9n\u00e8re elle-m\u00eame par oxydation.<\/p>\n<p>Toutefois, lorsque cette couche protectrice est endommag\u00e9e \u2013 p. ex. par une action m\u00e9canique (griffure), une exposition chimique ou des conditions de proc\u00e9d\u00e9 inad\u00e9quates \u2013 le m\u00e9tal sous-jacent peut oxyder. Les cons\u00e9quences peuvent en \u00eatre soit la formation de rouille, soit (sous certaines conditions thermiques et chimiques) l\u2019apparition du ph\u00e9nom\u00e8ne de <em>blacking<\/em>.<\/p>\n<h4><em>Blacking<\/em> <strong>[2]<\/strong> <strong>[3]<\/strong><\/h4>\n<p>Par <em>blacking<\/em>, on entend la formation d\u2019une couche fonc\u00e9e de magn\u00e9tite (Fe\u2083O\u2084) sur les surfaces m\u00e9talliques, en particulier sur l\u2019acier inox. Ce processus se manifeste typiquement \u00e0 des temp\u00e9ratures sup\u00e9rieures \u00e0 120\u202f\u00b0C et en pr\u00e9sence de vapeur obtenue \u00e0 partir d\u2019eau d\u00e9min\u00e9ralis\u00e9e, dans des conditions l\u00e9g\u00e8rement d\u00e9grad\u00e9es. Une couche passive d\u2019oxyde de chrome endommag\u00e9e ou incompl\u00e8te accroit le risque de formation de magn\u00e9tite.<\/p>\n<p>D\u00e9min\u00e9ralis\u00e9e et soumise \u00e0 un effet thermique, l\u2019eau r\u00e9agit et son pH passe d\u2019environ 7 \u00e0 5,6. Dans ces conditions, le fer diffuse \u00e0 travers la couche passive et oxyde, formant ainsi de la magn\u00e9tite (Fe\u00b2\u207aFe\u2082\u00b3\u207aO\u2084). Les diff\u00e9rences de valence de l\u2019ion fer entra\u00eenent la formation d\u2019une mol\u00e9cule bipolaire (illustration 3) qui adh\u00e8re fortement aux surfaces m\u00e9talliques. Des facteurs concomitants, tels que la pr\u00e9sence d\u2019ozone ou de CO\u2082, peuvent accentuer la formation de la couche de <em>blacking<\/em>, de mani\u00e8re analogue au m\u00e9canisme de <em>rouging<\/em>.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-747aeb2 e-flex e-con-boxed e-con e-parent\" data-id=\"747aeb2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-943469e e-con-full e-flex e-con e-child\" data-id=\"943469e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bb0ac42 elementor-widget elementor-widget-image\" data-id=\"bb0ac42\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"220\" height=\"220\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita3.jpg\" class=\"attachment-large size-large wp-image-48932\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita3.jpg 220w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita3-150x150.jpg 150w\" sizes=\"(max-width: 220px) 100vw, 220px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 3: structure de la mol\u00e9cule [4] <\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-63fe629 e-con-full e-flex e-con e-child\" data-id=\"63fe629\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4eef80a e-flex e-con-boxed e-con e-parent\" data-id=\"4eef80a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e342494 elementor-widget elementor-widget-text-editor\" data-id=\"e342494\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Ce ph\u00e9nom\u00e8ne n\u2019est pas nouveau en soi\u00a0: dans les usines pharmaceutiques [5], on l\u2019observe r\u00e9guli\u00e8rement depuis un certain temps d\u00e9j\u00e0, en particulier dans les syst\u00e8mes de production de vapeur et de condensat en acier inox. Par contre, dans les SRDM, le <em>blacking<\/em> n\u2019a \u00e0 ce jour que rarement \u00e9t\u00e9 document\u00e9, d\u2019o\u00f9 notre difficult\u00e9 initiale \u00e0 identifier la source du probl\u00e8me.<\/p>\n<h4>M\u00e9thodologie<\/h4>\n<p>Afin de pouvoir circonscrire les causes de mani\u00e8re syst\u00e9matique, toutes les \u00e9tapes de proc\u00e9d\u00e9s intervenant dans le retraitement ont \u00e9t\u00e9 analys\u00e9es\u00a0; pr\u00e9cisons qu\u2019il a rapidement \u00e9t\u00e9 possible de confirmer que <strong>les colorations observ\u00e9es n\u2019avaient, \u00e0 aucun moment, pr\u00e9sent\u00e9 un risque pour la sant\u00e9 des patients<\/strong>.<\/p>\n<p>L\u2019analyse s\u2019est en particulier concentr\u00e9e sur les aspects suivants\u00a0:<\/p>\n<ul>\n<li><u>Processus de nettoyage et de d\u00e9sinfection<\/u>: pr\u00e9l\u00e8vement d\u2019\u00e9chantillons d\u2019eau en amont et en aval de la cartouche \u00e9changeuse d\u2019ions, et dans l\u2019eau de rin\u00e7age final en laveur-d\u00e9sinfecteur. Comparaison de deux d\u00e9tergents, afin d\u2019exclure la formation de r\u00e9sidus.<\/li>\n<li><u>Processus d\u2019emballage<\/u>: analyse des mat\u00e9riaux d\u2019emballage (conteneurs, non-tiss\u00e9s, sachets, \u00e9tiquettes) pour d\u00e9tecter d\u2019\u00e9ventuelles interactions chimiques.<\/li>\n<li><u>Etat des instruments<\/u>: contr\u00f4le de la qualit\u00e9 mat\u00e9rielle et des caract\u00e9ristiques superficielles des instruments utilis\u00e9s.<\/li>\n<li><u>Processus de st\u00e9rilisation<\/u>: contr\u00f4le de la qualit\u00e9 mat\u00e9rielle et des caract\u00e9ristiques superficielles des parois des st\u00e9rilisateurs. Analyse d\u2019\u00e9chantillons d\u2019eau pr\u00e9lev\u00e9s dans l\u2019eau du g\u00e9n\u00e9rateur de vapeur et le condensat de vapeur. Examen endoscopique du g\u00e9n\u00e9rateur de vapeur, afin de d\u00e9tecter d\u2019\u00e9ventuels d\u00e9p\u00f4ts ou de la corrosion.<\/li>\n<\/ul>\n<h4>R\u00e9sultats et conclusions [6]<\/h4>\n<p>Les recherches ont conclu au fait que les colorations noires n\u2019\u00e9taient pas dues \u00e0 une seule cause, mais \u00e0 l\u2019effet conjugu\u00e9 de plusieurs facteurs. Il semblait en particulier que la qualit\u00e9 de l\u2019eau utilis\u00e9e lors du rin\u00e7age final ainsi que des diff\u00e9rences minimes dans la composition de la vapeur avaient une nette incidence sur le r\u00e9sultat.<\/p>\n<p>Les analyses en laboratoire ont mis en \u00e9vidence une concentration accrue de silicates (valeurs de r\u00e9f\u00e9rence selon l\u2019EN 285) [7] et d\u2019ions m\u00e9talliques dissous, qui ont contribu\u00e9 \u00e0 la formation de fines couches de magn\u00e9tite.<\/p>\n<p>Par ailleurs, les propri\u00e9t\u00e9s diff\u00e9rentes des mat\u00e9riaux utilis\u00e9s dans les composants des st\u00e9rilisateurs, p. ex. diff\u00e9rences entre le cuivre et l\u2019acier inox, ont \u00e9galement jou\u00e9 un r\u00f4le. Le cuivre peut lib\u00e9rer des ions m\u00e9talliques, qui se d\u00e9posent sur les surfaces en acier inox des st\u00e9rilisateurs.<\/p>\n<p>Les silicates, pr\u00e9sents en concentrations accrues dans l\u2019eau de rin\u00e7age final, provenaient de l\u2019eau de rin\u00e7age interm\u00e9diaire, tandis que les valeurs tr\u00e8s \u00e9lev\u00e9es de silicates dans le condensat de vapeur r\u00e9sultaient d\u2019une contamination par l\u2019eau du g\u00e9n\u00e9rateur de vapeur. De plus, des impuret\u00e9s ont m\u00eame \u00e9t\u00e9 observ\u00e9es \u00e0 l\u2019\u0153il nu dans l\u2019eau du g\u00e9n\u00e9rateur (illustration 4)\u00a0; celle-ci pr\u00e9sentait en outre des valeurs \u00e9lev\u00e9es en cuivre, phosphore, sodium et chlorure. Ces valeurs s\u2019\u00e9cartant de celles fix\u00e9es par la norme EN 285, des mesures correctives ont \u00e9t\u00e9 prises.<\/p>\n<p>Divers types de particules ont \u00e9galement \u00e9t\u00e9 mis en \u00e9vidence\u00a0:<\/p>\n<ul>\n<li>Des miettes jaune-brun (illustration 5), provenant probablement de r\u00e9sines \u00e9changeuses d\u2019ions et qui laissent penser que des cartouches \u00e9taient d\u00e9fectueuses.<\/li>\n<li>Des fibres et particules irr\u00e9guli\u00e8res noires (illustration 6), vraisemblablement dues \u00e0 des mati\u00e8res plastiques cassantes ou \u00e0 des joints d\u00e9fectueux.<\/li>\n<li>Des particules fibreuses blanches, \u00e9manant sans doute de mat\u00e9riel BOP.<\/li>\n<\/ul>\n<p>Il est difficile de d\u00e9terminer l\u2019origine exacte de ces diff\u00e9rentes particules, car elles pourraient \u00eatre dues au processus de nettoyage proprement dit, mais aussi \u00e0 des mat\u00e9riaux d\u2019emballage ou encore au processus de st\u00e9rilisation.<\/p>\n<p>De plus, des particules d\u2019abrasion blanches ont \u00e9t\u00e9 observ\u00e9es, provenant en particulier de conteneurs plus anciens. Ce constat indique que le processus, combin\u00e9 \u00e0 des d\u00e9tergents faiblement alcalins, \u00e9tait possiblement trop agressif pour le mat\u00e9riel utilis\u00e9.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-026b2fc e-flex e-con-boxed e-con e-parent\" data-id=\"026b2fc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-f5ea502 e-con-full e-flex e-con e-child\" data-id=\"f5ea502\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-edcbe10 elementor-widget elementor-widget-image\" data-id=\"edcbe10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"260\" height=\"306\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita4.jpg\" class=\"attachment-large size-large wp-image-48933\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita4.jpg 260w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita4-255x300.jpg 255w\" sizes=\"(max-width: 260px) 100vw, 260px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 4 : encrassement du g\u00e9n\u00e9rateur de vapeur<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e44b3a3 e-con-full e-flex e-con e-child\" data-id=\"e44b3a3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1ceaadf elementor-widget elementor-widget-image\" data-id=\"1ceaadf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"214\" height=\"142\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita5.png\" class=\"attachment-large size-large wp-image-48934\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 5 : miettes jaune-brun et fibres blanches [8]<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c22e49f e-con-full e-flex e-con e-child\" data-id=\"c22e49f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a9c4f67 elementor-widget elementor-widget-image\" data-id=\"a9c4f67\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"198\" height=\"118\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita6.png\" class=\"attachment-large size-large wp-image-48935\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 6 : particules irr\u00e9guli\u00e8res noires<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-82e721c e-flex e-con-boxed e-con e-parent\" data-id=\"82e721c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2d4a1d3 elementor-widget elementor-widget-text-editor\" data-id=\"2d4a1d3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4>Mesures correctives<\/h4>\n<p><strong>Optimisation des processus de nettoyage et de d\u00e9sinfection<\/strong><strong>\u00a0:<\/strong><\/p>\n<ul>\n<li>Changement de d\u00e9tergents, pour retenir ceux pr\u00e9sentant la meilleure efficacit\u00e9 d\u00e9tersive.<\/li>\n<li>Pour le rin\u00e7age interm\u00e9diaire, utilisation d\u2019eau d\u00e9min\u00e9ralis\u00e9e (au lieu d\u2019eau du r\u00e9seau).<\/li>\n<li>A intervalles r\u00e9guliers, r\u00e9alisation d\u2019un nettoyage approfondi et d\u2019un processus de passivation, afin de garantir une couche passive stable. Cela contribue \u00e0 accro\u00eetre la long\u00e9vit\u00e9 des instruments.<\/li>\n<\/ul>\n<p><strong>Optimisation du traitement de l\u2019eau<\/strong><strong>\u00a0:<\/strong><\/p>\n<ul>\n<li>Remplacement des \u00e9changeurs d\u2019ions et installation de filtres \u00e0 particules.<\/li>\n<li>Remplissage plus fr\u00e9quent du g\u00e9n\u00e9rateur de vapeur et ajustement des param\u00e8tres de commande (en collaboration avec le fabricant).<\/li>\n<li>Inspection des conduites entre les \u00e9changeurs d\u2019ions et les g\u00e9n\u00e9rateurs de vapeur pour d\u00e9tecter d\u2019\u00e9ventuels d\u00e9p\u00f4ts ou d\u00e9fauts.<\/li>\n<\/ul>\n<p><strong>Mesures prises sur les st\u00e9rilisateurs et dans les g\u00e9n\u00e9rateurs de vapeur<\/strong><strong>\u00a0:<\/strong><\/p>\n<ul>\n<li>R\u00e9alisation d\u2019un nettoyage complet, y compris <em>derouging<\/em>, <em>deblacking<\/em>, \u00e9lectropolissage puis passivation (illustrations 7 et 8).<\/li>\n<\/ul>\n<p>L\u2019ensemble de ces mesures a permis d\u2019\u00e9liminer compl\u00e8tement les colorations noires observ\u00e9es et d\u2019emp\u00eacher, \u00e0 ce jour, que celles-ci ne se reforment.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-36a85ab e-flex e-con-boxed e-con e-parent\" data-id=\"36a85ab\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-ed89d77 e-con-full e-flex e-con e-child\" data-id=\"ed89d77\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-74dd418 elementor-widget elementor-widget-image\" data-id=\"74dd418\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"410\" height=\"275\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita7.jpg\" class=\"attachment-large size-large wp-image-48936\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita7.jpg 410w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita7-300x201.jpg 300w\" sizes=\"(max-width: 410px) 100vw, 410px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 7 : chambre du st\u00e9rilisateur apr\u00e8s nettoyage et passivation<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-28516e9 e-con-full e-flex e-con e-child\" data-id=\"28516e9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f0a30ea elementor-widget elementor-widget-image\" data-id=\"f0a30ea\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"416\" height=\"275\" src=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita8.jpg\" class=\"attachment-large size-large wp-image-48937\" alt=\"\" srcset=\"https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita8.jpg 416w, https:\/\/sssh.ch\/wp-content\/uploads\/2025\/12\/Zita8-300x198.jpg 300w\" sizes=\"(max-width: 416px) 100vw, 416px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Illustration 8 : g\u00e9n\u00e9rateur de vapeur apr\u00e8s nettoyage et passivation<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4a713e2 e-flex e-con-boxed e-con e-parent\" data-id=\"4a713e2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-af0d531 elementor-widget elementor-widget-text-editor\" data-id=\"af0d531\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2>Conclusion<\/h2>\n<p>Certes rare, le <em>blacking<\/em> peut constituer un v\u00e9ritable casse-t\u00eate pour le retraitement des dispositifs m\u00e9dicaux\u00a0; il convient donc de ne pas le sous-estimer et de le surveiller en permanence. D\u2019o\u00f9 l\u2019importance d\u2019une bonne collaboration entre tous les services (internes et externes) concern\u00e9s\u00a0: technologie m\u00e9dicale, laboratoires d\u2019analyse d\u2019eau, professionnels d\u2019autres SRDM, fabricants de st\u00e9rilisateurs, organismes d\u2019essai de mat\u00e9riaux, validateurs, ou encore fabricants de produits chimiques et d\u2019instruments.<\/p>\n<p>Le chemin fut long et ardu, notamment parce que, dans un premier temps, les diff\u00e9rents sp\u00e9cialistes se sont renvoy\u00e9 la balle et ont d\u00e9gag\u00e9 leur responsabilit\u00e9. Pourtant, nous avons constat\u00e9 que ce ph\u00e9nom\u00e8ne \u00e9tait un probl\u00e8me multifactoriel, qui ne pouvait \u00eatre compris et r\u00e9solu qu\u2019avec la bonne volont\u00e9 et les efforts conjugu\u00e9s de toutes les parties prenantes. Il est donc judicieux de r\u00e9unir rapidement tous les services concern\u00e9s autour d\u2019une m\u00eame table. En effet, seules une d\u00e9marche syst\u00e9matique, des analyses pouss\u00e9es et une collaboration interdisciplinaire ont finalement permis d\u2019identifier distinctement \u2013 et d\u2019\u00e9liminer durablement \u2013 les causes du probl\u00e8me.<\/p>\n<p>Le pr\u00e9sent rapport d\u2019exp\u00e9rience a pour but d\u2019aiguiser la sensibilit\u00e9 \u00e0 ce type de modifications techniques du mat\u00e9riel et de renforcer l\u2019assurance de la qualit\u00e9 dans les SRDM.<\/p>\n<p>\u00a0<\/p>\n<h2>Bibliographie<\/h2>\n<p>[1] Joachim Schlegel, Nichtrostender ferritischer Stahl, Book \u00a92025<\/p>\n<p>[2] Fachartikel Chemie Plus 10-2015, reinraum \/GxP, pp. 32-36<\/p>\n<p>[3] Erfahrungen in Derouging und Deblacking, Intervenant\u00a0: Karl Enzler, propri\u00e9taire &amp; pr\u00e9sident du Conseil d\u2019administration de Beratherm AG<\/p>\n<p>[4] ChemNet Global Chemical Network, Iron Oxide Black 318, Nov. 19, 2018<\/p>\n<p>[5] Fachartikel contamination control report 1\/2016 Rouging und Blacking in pharmazeutischen Anlagen<\/p>\n<p>[6] Dr. Gerhard Kirmse, Philipp Scholz, Ergebnispr\u00e4sentation B.Braun Sharing Expertise, 2025<\/p>\n<p>[7] Kevin Ruwisch, VSM-Untersuchung magnetischer Eigenschaften von epitaktischen Magnetitschichten, Bachelorarbeit vorgelegt im Rahmen der Pr\u00fcfung f\u00fcr den Zwei-F\u00e4cher-Bachelor-Studiengang im Teilstudiengang Physik, Osnabr\u00fcck, 21.11.2016<\/p>\n<p>[8] Prof. Ulrike Diebold, Gareth Parkinson, PhD, Dr. Florian Aigner, Alle News an der TU Wien, Die Rost-Formel, 5.12.2014<\/p>\n<p>[9] Alexander Liks, Korrosions &#8211; und Aufkohlungsprozesse von Dampferzeuger &#8211; Werkstoffen unter Ber\u00fccksichtigung der Achedepositionen, 19.11.2013<\/p>\n<p>[10] Detlef Leistner, Responsable SRDM au KSLB, site de Liestal, Colorations sur les surfaces en acier inoxydable, forum 1 2017<\/p>\n<p>[11] Hygieneforum.ch, Rouging : d\u00e9p\u00f4ts dans les syst\u00e8mes d\u2019eau purifi\u00e9e, 12.07.2023<\/p>\n<p>[12] Materials Science and Technology, Black oxide coating and its effectiveness on prevention of hydrogen uptake, 2018<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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