Provisional Reprocessing of Medical Devices in Field Hospitals: Evaluation of Chemical Approaches for Feasibility and Effectiveness.

Objectives: Field hospitals are deployable hospitals that treat patients directly on site before they are transported to permanent medical facilities. The supply of sterile surgical instruments is important, but not every field hospital is equipped with a sterile processing department. This concept therefore attempts to test a method of reprocessing surgical instruments under field conditions that can at least provide a provisional form of disinfection in case of logistic breakdowns.

Methods: Development, testing, and evaluation of a provisional chemical reprocessing procedure for reusable surgical instruments using hydrogen peroxide. The evaluation was carried out visually, microbiologically, and with regard to material damage.

Results: The concept is easy to implement but requires thorough training. The reprocessed surgical instruments were free of residual protein, showed no bacteriological growth, and were not damaged by the chemical reprocessing even after 10 cycles.

Conclusions: Provisional reprocessing of reusable surgical instruments seems possible using high-level chemical disinfection with hydrogen peroxide (3% for 150 minutes or 7.5% for 30 minutes) in case of necessity due to logistic breakdowns and patients that need immediate treatment. In addition, a multibarrier approach that includes hygiene measures and antibiotic stewardship is required to effectively reduce the risk of surgical site infections.