"Yes, we sterilize all of them."
"No, you don't. You disinfect your scopes — you don't sterilize them."
But if high-level disinfection is as unreliable and unpredictable as
many make it out to be and if flexible scopes are fundamentally diffi-
cult to decontaminate, maybe scopes should be sterilized.
"We should be moving away from high-level disinfection and going
toward sterilization due to uncertainty in the process," says Mr. Lavanchy.
"A gaseous approach is more reliable because it can get to surfaces with-
in the endoscope that liquid germicides may not be able to reach."
Theoretically, he says you could sterilize endoscopes with ethylene
oxide, but this can be dangerous for technicians because the gas may
be carcinogenic. "That's not the only problem," says Mr. Lavanchy.
"Ethylene oxide may degrade the devices."
Many consider flexible scopes to be surgical devices, no longer used
solely for diagnosis, but to snare polyps and biopsy lesions. "Would
you use instruments that aren't sterile for surgery?" asks Ms. Ofstead.
It's a question, unfortunately, her study has already answered.
OSM
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