Challenging the Sterrad 100NX sterilizer with different carrier materials and wrappings under experimental “clean” and “dirty” conditions

Comparative evaluation of the microbicidal activity of low-temperature sterilization technologies to steam sterilization

“…In contrast, the data demonstrate how important cleaning is prior to sterilization because salt and organic matter left on instruments can interfere with sterilization. These results, and those of other investigators, 5,9,12,13 highlight the importance of real-time monitoring methods prior to sterilization that are reliable and validated and that assess the effectiveness of cleaning that is predictive of microbial contamination, infection risk, and/or an SAL of 10 −6 . 14 Current assessment tools (eg, visual, adenosine triphosphate [ATP]) are not predictive of microbial contamination or infection risks.…”

“…2-4,8 The criticality of cleaning was reconfirmed by Alfa et al 5 in a classic study that evaluated various LTS technologies and showed sterilization failure in the presence of salt, serum and lumen test units. Given that organic material and salts are known to influence the sterilization capacity of LTS technologies, 5,8,9 we investigated the impact of inadequate cleaning and salt or crystalline residues on the efficacy of the sterilization technologies used in the United States. One LTS technology cleared in the United States for medical and surgical instruments, a hydrogen peroxide-ozone sterilizer, was not evaluated in this study because it was not available at UNC Health Care.…”

“…10 The literature contains a paucity of information on the comparative microbicidal activity of the sterilization technologies cleared by the Food and Drug Administration (FDA) for sterilizing medical and surgical devices. 5,[8][9][10][11][12] For example, no studies in the peerreviewed literature have compared 4 sterilization methods used commonly in US healthcare facilities, and only a few studies have evaluated 3 sterilization technologies. 5,11,12 To our knowledge, no studies in the peer-reviewed literature have evaluated the microbicidal activity of the FDA-cleared VHP sterilizer (Table 1) used for sterilization of medical and surgical instruments.…”

Hydrogen peroxide plasma sterilization of a waterproof, high‐definition video camera case for intraoperative imaging in veterinary surgery

“…In addition, although hydrogen peroxide plasma has been shown to be highly effective, thorough physical cleaning of "dirty" instruments prior to this method of sterilization is essential to achieve consistent results. 15 Physical organic and inorganic residues left on the instruments can prevent effective sterilization by chemical methods and may have contributed to the single positive culture in this study. Alternative methods for intraoperative photography have been previously reported, but these typically include the use of disposable plastic bag covers.…”

“…This is even more relevant in a clinical scenario in which the camera case would not be expected to be contaminated by a high bacterial load (eg, immersed in contaminated broth) and would not be directly in contact with the patient for subsequent reinfection. In addition, although hydrogen peroxide plasma has been shown to be highly effective, thorough physical cleaning of “dirty” instruments prior to this method of sterilization is essential to achieve consistent results . Physical organic and inorganic residues left on the instruments can prevent effective sterilization by chemical methods and may have contributed to the single positive culture in this study.…”