Types of sterilization in hospitals and which instruments they suit

Why the method must match the instrument

Sterilization only works on clean, dry and correctly packed devices, so surgical instrument cleaning and sterilization are always planned as one chain, as described in the reprocessing cycle. Within that chain, the sterilization method is fixed by the device, not by convenience. A method that is excellent for stainless steel can damage plastics, adhesives, cameras or batteries.

The first reference is always the manufacturer's IFU, which lists validated methods and parameters. If a method is not listed, the hospital should not assume compatibility.

Saturated steam: the default for heat-tolerant instruments

Steam under pressure in a pre-vacuum sterilizer is the standard sterile processing technique for metal instruments, many rubber and textile items and rigid optics that the maker has approved for autoclaving. Typical cycles run at 121 °C or 134 °C with defined holding time and drying, as explained in steam sterilization temperature and time. Steam is fast, non-toxic, well understood and easy to monitor.

Its limits are heat and moisture. Items with electronics, many plastics and certain adhesives do not survive repeated steam cycles. Drying is also important: wet loads compromise the sterile barrier. REDA's laparoscopy range includes laparoscopes of 5 and 10 mm that the manufacturer describes as autoclavable (REDA laparoscopy instruments), which shows how steam compatibility is a specified product property rather than an assumption.

Low-temperature hydrogen peroxide and plasma

Hydrogen peroxide gas or plasma cycles run at lower temperature and without long aeration, which suits heat-sensitive devices such as certain flexible instruments, cameras and cables. The trade-offs are load restrictions: cellulose-based packaging, linen and some lumens can be incompatible, and instrument length and diameter limits apply.

Containers for these processes must be designed for them. REDA's Plasma container model is described as suitable for both steam and low-temperature plasma sterilization, and its accessory range includes Teflon filters (REDA sterilization containers). Always confirm with the sterilizer manufacturer that a specific container is validated in that machine.

Ethylene oxide and dry heat

Ethylene oxide is a low-temperature gas process used for heat- and moisture-sensitive items. It needs long cycles and an aeration phase, and it involves toxic gas with strict room, ventilation and monitoring requirements, so many hospitals use it through an industrial service rather than in-house.

Dry heat uses hot air at high temperature for long exposure times and is used for items damaged by steam, such as some powders, oils or sharp instruments, where permitted. It is slow, poorly suited to textiles and plastics, and rarely used for routine surgical sets. Chemical liquid immersion and peracetic acid systems are used for some endoscopes, but they are high-level disinfection or special-purpose methods rather than a general replacement for the sterilization of packed instrument sets.

How to choose and what to document

For a broader view of what a department needs for these processes, see the CSSD equipment list. Beckfinity's specialists can help you review container systems and instruments for your sterilization methods. Request a consultation.

• Read the IFU of each device and list validated methods.
• Group devices by method so that loads are not mixed.
• Confirm packaging and container compatibility with each sterilizer.
• Validate cycles and monitor with chemical and biological indicators.
• Keep load records so any set can be traced.
• Check current requirements with your licensing authority (DHA, DOH or MOHAP).