By Rob Scarfe | Business Development Manager | Vygon (UK) Ltd.

I often visit oncology units, where we talk a lot about closed systems and the protection the devices can offer the clinical team whilst they administer systemic anti-cancer therapies (SACT). But the more people I speak to, the more I realise how much confusion there is about what ‘closed’ actually means.

It is vitally important that the difference between a simple ‘closed system’ and a ‘closed system drug-transfer device (CSDTD)’ is properly understood. A failure to do so could mean that nurses are under the impression they are being fully protected from exposure to potentially dangerous chemotherapy drugs, when in reality, they may not be.

The key definition for a CSDTD, like Vygon’s Qimono, is that it mechanically prohibits the transfer of environmental contaminants into the system and the escape of hazardous drug, or vapour concentrations, outside the system. In the hierarchy of controls defined in COSHH for chemotherapy as a hazardous substance it comes at the very top – giving the most effective protection by physically removing the hazard.

Meanwhile, a closed device has some features aimed at preventing exposure to SACT but it’s not a completely ‘closed’ system’ covering the entire chemo administration process from drug preparation to waste disposal. The benefit of the needle-free devices is that they don’t exchange unfiltered air, or contaminants, with the adjacent environment through features such as an auto-closure system and permanent connection but they just focus on specific points of the chemo administration process.

In the hierarchy of controls, the closed system falls under ‘isolating people from the hazard’. That’s more effective than just relying on personal protective equipment (PPE) but not as effective eliminating the risk altogether.

The guidance from National Institute for Occupational Safety and Health (NIOSH) in the US is unequivocal when it comes what a CSDTD is. Furthermore, it advises asking for peer reviewed, independent published studies for each component of the system to validate its effectiveness and that it meets the NIOSH definition of closed.

That’s the only way you can be sure that closed means closed.


Sign up for a trial

We have trials about to launch for Qimono in Trusts up and down the country. If you are interested in seeing our closed system drug-transfer device in action for yourself do email me via


Come and say hello

We look forward to showing you all the benefits of Qimono to protect your clinical team at meetings and conferences up in the next few months.

See us at:

  • Aseptic Preparation and Dispensing of Medicines 3 to 5 July in Leeds
  • UKONS from 16 to 17 November in Glasgow.