The Principles of Medical Device Decontamination

Disinfectants for Medical Devices

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Why we need disinfectants

Medical devices that are reusable need to be cleaned and disinfected as part of the decontamination process, whether they will be used immediately on a patient, or subject to further processing (for example, sterilisation) prior to use on patients. The reason for the disinfection step is because: a. We must limit the number of microorganisms that are present on reusable medical devices to allow safe handling by operators in the inspection and packing stage prior to subsequent processing, and to ensure that large numbers of microorganisms are not presented to a final process i.e. terminal sterilisation, or b. The reusable medical device will not be used invasively, hence does not need to be sterilised, but does need to be processed (disinfected) to remove as many microorganisms as possible. The disinfection step for a) or b) above will often be thermal where possible, with the load being heated to approximately 90°C, usually in a washer-disinfector, for a set period of time. Some medical devices, however, such as flexible endoscopes, cannot be thermally disinfected due to their thermolabile nature (thermolabile devices are typically defined as devices that will not withstand 60°C), so these medical devices are disinfected using chemical disinfectants i rather than thermal disinfection.

Disinfection

While the definition of sterilisation means complete destruction of all microorganisms (at least to a theoretical probability), the term disinfection is more general in nature,

i Some chemical disinfectants can also be used for sterilisation. This has not been discussed in this chapter however, you can read more https://www.cdc.gov/infection-control/hcp/ disinfection-and-sterilization/index.html

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