It appears that there still exists confusion as to the definitions of sterility and processing methods. Sterile or aseptic tissue recovery by itself is mistakenly considered as a method that will result in the supply of sterile grafts hence making terminal sterilization unnecessary (Marrale et al. 2007) . Recovery under aseptic conditions seeks to ensure that no further bioburden is introduced from the environment but does not remove existing bioburden in the tissue (Vangsness 2004; Vangsness et al. 2003) . Tissue banks must use disinfection steps and/or terminal sterilization to accomplish sterilization of existing bioburden. Furthermore, aseptic recovery occurring in a surgical operating room can only result in, at best, a sterility assurance level (SAL) of 10 -3 , and then only if properly validated, versus a terminal sterilization SAL of 10 -6 . Sterility assurance level gives the probability of there being viable microorganisms on a particular graft unit, instrument, etc. A SAL of 10 -6 indicates there is only at most a 1 out of 1,000,000 chance that a viable organism exists with any single graft compared with an SAL of 10 -3 which indicates a 1 out of 1,000 chance (Vangsness et al. 2003) . Some tissue banks choose to use terminal sterilization to increase the likelihood of the safety of their tissue. If the allograft can be guaranteed to a SAL of 10 -6 then it may possibly possess an even lower degree of infection risk than an autograft procedure (Bryans et al. 2010; Katz et al. 2008) .