To sterilise or disinfect--that is the question

Few hospitals have the in-house technology to sterilise heat and moisture sensitive reusable devices, yet the use of this type of equipment is increasing in all types of surgery. In general terms and because of limitations of existing technology, instruments and equipment have been divided into three categories based on the degree of risk of infection involved in their use: 1. Instruments and equipment which come into contact with intact skin must be cleaned before they are used. 2. Instruments and equipment which come into contact with non-sterile tissue (other than intact skin) must be disinfected before they are used. 3. Instruments and equipment which enter, or are capable of entering, the vascular system or tissue that would be sterile under normal circumstances must be sterilised before they are used. Unfortunately, some devices that should be sterilised are only disinfected in liquid chemical disinfectants. Traditional low-temperature sterilisation systems such as ethylene oxide (EtO) and low temperature steam and formaldehyde (LTSF) have many disadvantages and it is undoubtedly for this reason they have been relegated to a few specialist sterile service departments in the UK.