M A Y 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 4 7
each have their pluses and minuses, and the right
choice for your facility depends on the type of instru-
ments you need to sterilize, how quickly you need to
do it and the financial constraints in which you oper-
ate.
Ethylene oxide (EtO), for example, has a light
molecular weight that makes it extremely effective at
penetrating instruments, especially those with long
lumens, to kill spores and bacteria. However, it requires a long chemical exposure
time and is a human carcinogen. In addition, there are a lot of restrictions associ-
ated with its use, from OSHA guidelines about employee exposure, to the EPA's
concerns about how much can be released into the environment, to local laws
that might require members of your reprocessing team to obtain user permits
before activating the units.
Hydrogen peroxide is another more practical option, and arguably the most
commonly used in surgical facilities. Although it doesn't have the penetrating
abilities of EtO, it's a powerful oxidizer. The vast majority of devices that require
low-temp sterilization are compatible with hydrogen peroxide. It's also a chemi-
cal that our bodies produce naturally. At high concentration levels hydrogen per-
oxide can hurt microorganisms and people, but at the end of a sterilization cycle
you end up with inert chemicals — water and hydrogen — that are no longer
dangerous. Unlike other low-temperature sterilants, particularly EtO, the byprod-
ucts of hydrogen peroxide cycles won't harm your staff.
Hydrogen peroxide, however, is very sensitive to humidity, a drawback that
can lead to aborted cycles. Facilities with hydrogen peroxide sterilizers should
attempt to maintain an abort rate of less than 10%, which would be extremely
high and unacceptable for steam sterilization. Even facilities that manage cycles
closely will have abort rates in the 2% to 4% range. Investing in a unit that auto-
matically checks humidity levels in the sterilization chamber before starting a
z
BEFORE
ALL ELSE
Proper clean-
ing is still the
essential first
step to low-
temperature
sterilization.
