Post-Operative Medical Device Disinfection

Post Operative Medical Device Disinfection Process

Post operative medical device disinfection process is a crucial step to eliminate the microorganisms after the medical device is used on a patient, therefore, if the medical device is reusable, we should be given due consideration to post-operative medical device disinfection and sterilization.

In order to have an effective decontamination, instructions of manufacturer of reusable medical device should be considered, therefore, manufacturer should provide an information that includes instructions for reprocessing devices and device accessories safely and preparing them for reuse. 

Reprocessing Stages

Reprocessing of medical devices begin with following 3 steps:

  • Point-of-Use Processing: Reprocessing begins with processing at the point of use (i.e., close proximity to the point of use of the device), to facilitate subsequent cleaning steps. We define this as point-of-use processing, which includes prompt, initial cleaning steps and/or measures to prevent drying of soil and contaminants in and on the device.
  • Thorough Cleaning: The device should be thoroughly cleaned after the point-of use processing. Generally, thorough cleaning is done in a dedicated cleaning area. Devices that will likely not become contaminated with pathogens during use (e.g., room vital signs monitor) may not require disinfection, and therefore may be suitable for use after cleaning only.
  • Disinfection or Sterilization: Depending on the intended use of the device, the device should be disinfected or sterilized, and routed back into use.
FDA Guidance Reprocessing Medical Devices in Health Care Settings

Click here to learn how to clean and sterilize the surgical power tool systems.

Spaulding Classification According to Potential Risk of Infection

Spaulding Classification is a system that allows a classify instruments and items used in patient care according to infection risk into “critical”, “semicritical”, and “noncritical” categories.

According to these classification while disinfection is sufficient to kill microorganisms on some instruments, sterilization is absolutely necessary for other instruments.


• Penetrate or enter normally sterile tissue or spaces, including the vascular system
• Surgical instruments (elevators, bone files, rongeurs, forceps, etc.)
• Must be sterilized between uses or used as single‐use disposable devices
• Goal: Sterility = devoid of all microbial life


• Contact mucous membranes and non‐intact skin
• Mouth mirrors, cheek retractors, handpieces
• Must be sterilized or immersed in high‐level disinfectant
• Goal: High‐level disinfection = free of all microorganisms except low numbers of bacterial spores


• Contact intact skin
• BP cuffs, electrocardiogram (EKG) leads, stethoscopes
• Disinfect using a low level disinfectant
• Goal: Kill vegetative bacteria, fungi, viruses

Reprocessing Scheme

Another factor to consider is to have a validated reprocessing. Many people claim that each instrument has different features, therefore, each instrument should be treated separately. But the general framework is the same for all instruments. Basic scheme should be as follows:

Resistance of Microorganisms to Germicidal Chemicals

If we would like to sort the microorganisms according to their resistance, the order of them is going to be like on the table below:

Modified from Russell and Favero.13, 344

As it is seen on the table above, viruses like HIV and Hepatitis are most least resistant to germicidal chemicals. Sterilization process is likely to kill most of microorganisms.

Possible Viruses on Medical Instruments


Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus.

Hepatitis A

Hepatitis A is not a chronic disease. Infected person by Hepatitis A is recovered usually within a 6 months. Hepatitis A vaccine is effective around 95 % of cases and last for at least 15 years and person’s entire life.

Hepatitis B

Hepatitis B can be acute or chronic. If an infant is exposed to this virus that will remain chronically infected with HBV. Hepatitis B vaccine is effective 5 to 7 years.

Hepatitis C

Hepatitis C can be acute or chronic too. But there is no vaccine against Hepatitis C. It can be prevented only by avoiding contact with contaminated blood.

HIV (Human Immunodeficiency Virus)

HIV virus is a virus that exerts its main effects on the immune system. 

owadays, drugs developed for HIV prevent the virus from multiplying in the body and its immunosuppressive effect, enabling HIV-positive people to live a long and healthy life. For this, it is important to start treatment early and to continue regularly under doctor’s control. 

There is no definitive treatment for HIV. Virus cannot be completely destroyed in the body, but it can be controlled with drugs. Purpose of treatment; to prevent the virus from happening again. Thus, the virus is less likely to develop many mutations that may be resistant to treatment.


Reprocessing of medical devices after the operation is a process to be careful. Monitoring the effectiveness of the sterilization equipment is essential. 

There are several disinfectants that kill these kind of viruses within 2-3 minutes. But the safest decontamination method is sterilization. You should classify your instruments in terms of critical scheme and you should decide whether they need sterilization or disinfection.

Healthcare professionals should be vaccinated periodically and all process should be automated as far as possible in order not to be exposed the viruses.

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