Page 17 - The Care and Handling of Flexible Scopes v3

Care of Flexible Endoscopes

Figure 10 – Flexible Endoscope in Sterilisation Tray

The manufacturer validates an endoscope for terminal sterilisation based on two criteria:
material compatibility (ie, whether or not the material will tolerate the sterilisation method)
and sterilisation efficacy (ie, whether or not the item can be rendered sterile using a
particular method). An autoclave, or steam steriliser, uses high heat under pressure and is
the oldest and most reliable sterilisation method. However, some endoscopes cannot
tolerate high heat and will need to be processed in a low-temperature alternative.

A variety of low-temperature sterilisation machines use a gas for the sterilant agent:
Ethylene Oxide (EO), Hydrogen Peroxide Gas Plasma or Hydrogen Peroxide Gas Vapour. EO
is the oldest and most effective low-temperature gas sterilisation method but requires a
long aeration time (up to 14 hours), which may delay surgery schedules. Hydrogen peroxide
gas is a newer method for low-temperature sterilisation. The entire cycle time for hydrogen
peroxide sterilisation is quick, with a complete sterilisation cycle as short as 35-45 minutes.
The machine used for this method quickly converts hydrogen peroxide gas to plasma
(STERRAD) or to vapour (STERIS V-PRO) and has no residue, doesn’t need any aeration time,
and doesn’t require any special venting or drains.

Sterilisers using peracetic acid are considered immediate-use sterilisers. The machine
requires a drain, water plumbing and special filters for the water input. A flexible endoscope
using this process will be wet when cycle is done, which requires the endoscope to be used
immediately following sterilisation. Consult the endoscope manufacturer’s instructions to
ensure that an endoscope can be sterilised using this method.

Endoscopes can be processed with chemicals for high-level disinfection (HLD) or immediate-
use sterilisation. Common chemicals for either HLD or immediate-use sterilisation include

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