Characteristics of an ideal low-temperature sterilization process, Table 10. Current low temperature sterilizing agents are: Ethylene Oxide (EtO), steam formaldehyde (LTSF), vaporized hydrogen peroxide (VH2O2) and ozone (O3). Do not use a lower category of disinfection or cease to follow the appropriate disinfectant recommendations when using probe covers because these sheaths and condoms can fail. Hang endoscopes in a vertical position to facilitate drying. Accessed March 17, 201839. Terminal sterilization by radiation sterilization is elegantly simple. Denver, CO, AORN, 2006; 555–5633. Post-mortem vital staining showed dose-related toxicity from the enzymatic detergent to the corneal endothelium. The very low surface tension of LCO2 facilitates penetration into the interior of the tissue, thereby allowing inactivation of embedded pathogens. Follow this decontamination process with a terminal disinfection, using a 1:100 dilution of sodium hypochlorite. If the spill contains large amounts of blood or body fluids, clean the visible matter with disposable absorbent material, and discard the contaminated materials in appropriate, labeled containment. Medical device used to diagnose and treat diseases associated with the liver and the pancreas. These should then be approved by the facility governing body. Factors affecting the efficacy of sterilization, Table 11. Ophthalmology 2017; 124:768–77548. ethylene oxide, and sterilization by radiation, e.g. Retain sterilization records (mechanical, chemical, and biological) for a time period that complies with standards (e.g., 3 years), statutes of limitations, and state and federal regulations. Prion are not microorganisms and are more resistant than conventional microorganisms. For example, achieving terminal sterilization with these methods frequently compromises the osteogenic and biomechanical properties of the allograft. Biocompatibility is expected for any implant material. Accessed March 17, 201842. It It is a well-accepted principle that sterile drugs should be manufactured using aseptic processing Although developed specifically for cataract surgery, the recommendations in this document are also relevant for instruments used in other intraocular surgical procedures. Ocular surgical pharmacology: corneal endothelial safety and toxicity. The regulatory environment for products manufactured using aseptic processes is increasingly challenging in the United States and in Europe.39 Finally, sterilization and packaging influence shelf-life which is important to the manufacturer as well as the hospital administrator and the surgeon. The ultrasonic unit should be designated for cleaning medical instruments and preferably should only be used for ophthalmic instruments. Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update, Prepared by: Reprocessing Guideline Task Force, Bret T. Petersen BT, Cohen J, Hambrick RD III, Buttar N, Greenwald DA, Buscaglia JM, Collins J, Eisen G. Gastrointesti Endosc 2017; 85:282–294. Some sterilizer IFU permit interruption of the drying phase under certain circumstances.39 The risk for infection resulting from sterile moisture in the container or on the instruments when the undried (wet) and unwrapped instruments are sterilized for sequential same-day use and are brought from the sterilizer directly to the operating room in a covered containment device has not been established. Processing Patient-Care Equipment Contaminated with Bloodborne Pathogens (HBV, Hepatitis C Virus, HIV), Antibiotic-Resistant Bacteria (e.g., Vancomycin-Resistant Enterococci, Methicillin-Resistant Staphylococcus aureus, Multidrug Resistant Tuberculosis), or Emerging Pathogens (e.g., Cryptosporidium, Helicobacter pylori, Escherichia coli O157:H7, Clostridium difficile, Mycobacterium tuberculosis, Severe Acute Respiratory Syndrome Coronavirus), or Bioterrorist Agents, 10. Compare the reprocessing instructions provided by both the endoscope’s and the AER’s manufacturer’s instructions and resolve any conflicting recommendations.