Infection Control Considerations In The Cleaning, Disinfection, And Sterilization Of Complex Surgical Devices

Abstract

Background
Complex surgical devices, such as endoscopes and robotic instruments with intricate lumens and joints, pose significant infection control risks due to persistent bioburden, biofilms, and reprocessing failures leading to healthcare-associated infections (HAIs) like surgical site infections.​

Methods
This narrative review synthesizes evidence from guidelines (WHO, CDC, AAMI, ISO), experimental studies, observational data, and outbreak investigations on cleaning, disinfection, and sterilization of complex devices, focusing on design challenges and validation in diverse settings.​

Results
Studies reveal residual soil and biofilms persist post-reprocessing, with contamination rates up to 8.69% in endoscopes; outbreaks link failures to inadequate precleaning, AER malfunctions, and drying lapses; innovations like AI monitoring and RFID reduce errors by 20-99%.​

Conclusions
Robust protocols integrating automation, training, and emerging technologies (e.g., nanomaterials, robotics) are essential for sterility assurance; addressing design gaps and human factors will minimize HAIs across resource settings.​