Impact of transportation environment on contaminated instruments before reprocessing: A study challenging reprocessing practices

Authors

Rubak P., Bruun N.H., Kirmse G. and Bundgaard K.

Original article

Heliyon (in press) 

Introduction

Prompt and effective reprocessing of reusable surgical instruments is critical to avoid corrosion and ensure cleaning efficiency. Guidelines differ on whether to keep instruments moist or dry when moving them from the operating room to the Central Sterile Services Department. Moist conditions may aid cleaning but risk corrosion, while dry conditions better protect metal surfaces. This study evaluated how moist versus dry transport environments influence instrument cleanliness and surface integrity.

Aim

To determine whether moist or dry transport conditions affect residual protein contamination and corrosion of surgical instruments after standard reprocessing, to refine hospital reprocessing protocols.

Summary of Methods and Key Findings

At Aarhus University Hospital, Denmark, surgical instruments were transported either under moist conditions (sterile water-soaked towels) or dry conditions before undergoing standard cleaning. Protein residues were quantified using the BCA assay, and corrosion was visually assessed. Among 173 instruments tested for protein, mean residues were similar: 27.7 µg (dry) versus 26.9 µg (moist) (p = 0.56); eight exceeded 75 µg. Surface inspections of 880 instruments showed significantly more corrosion in moist-stored instruments both with fretting (p < 0.001) and without (p = 0.05). No significant differences emerged for pitting (p = 0.29) or staining (p = 0.98). Scissors were most prone to corrosion regardless of transport environment (p < 0.001).

Conclusions

Moist transport did not influence residual protein levels, however, significantly increased both the extent and severity of corrosion. This research provides valuable insights for sterile reprocessing protocols, suggesting that although timely reprocessing remains important, a moist transportation environment may have a greater impact on instrument surface integrity than previously recognized.

Careful control of the transport environment is therefore essential to prevent corrosion and ensure patient safety.