Prions cling to surgical equipment

The National Institute for Health and Clinical Excellence warned equipment at risk of contamination was being mixed up with other instruments.

NICE said proper records must be kept to ensure sets were maintained together during certain brain and eye surgery.

If this could not done, it recommended the use of disposable equipment.

Some 39 types of brain and eye surgery are covered by the recommendations, which are being consulted on until August.

It is most important that systems are put in place to ensure no instruments are swapped between set in high-risk procedures NICE spokesman

The draft guidance has been drawn up because of fears over vCJD transmission, the human form of bovine spongiform encephalopathy (BSE), also known as 'mad-cow disease'.

Over 150 people have died from vCJD since 1996.

New rules were introduced six years ago by the Department of Health to improve cleaning, tracing and quarantining of equipment.

They said equipment that is being used must be kept together - to help minimise the risk of future infection and allow equipment to be traced if a patient is diagnosed with an infection later on.

But advisers warned these safety precautions were not being followed as they estimated instruments become mixed up, mostly during the cleaning process, about 50% of the time.

No system of decontamination will yet completely removed the prion proteins associated with vCJD, but high pressure sterilising and brushing does lower the risk. It is not known what the risk of transmission is.

NICE said: "It is most important that systems are put in place to ensure no instruments are swapped between set in high-risk procedures and that the effectiveness of these systems is demonstrated through regular audit."

A Department of Health spokesman said government advice should be followed, adding "bad practice should not happen".