Methods of reprocessing complex medical equipment.

The choice as to which of the two gaseous processes is best suited to individual hospital needs is a difficult one. Very few items are unable to tolerate 73 degrees C (LTSF) and these few can withstand 37 degrees C or 55 degrees C (EO). Unfortunately, LTSF is a 'moist' process and sterilizers have a poor history of providing sterilization without modification, and consequently few are used. Ethylene oxide is more reliable, but environmental hazards are greater and running costs high. Both processes are time-consuming and the use of sporicidal disinfectants such as glutaraldehyde is often the only practical alternative. Before purchasing any gaseous sterilizer it is essential to consider throughput and the availability of alternative processes. It may prove sensible to share facilities or at least offer a regional facility. It is certainly not worthwhile purchasing expensive gas sterilizers for reprocessing inexpensive single-use items or for those that require disinfection only. Low temperature steam is safe, inexpensive and no special environmental provisions are necessary. It is, however, not a sterilization process. Disinfectants, hot water and steam will continue to be the only suitable methods for reprocessing items outside the hospital sterile supply department or disinfection unit. Concern over the decontamination of blood-stained instruments following use on patients with hepatitis B or HIV has led to an upsurge of interest in boilers and inexpensive bench top ovens and autoclaves. Such processes are likely to prove more effective than disinfectants but should heat treatment prove impractical then 2% glutaraldehyde or 70% alcohol may be used.(ABSTRACT TRUNCATED AT 250 WORDS)