High-level disinfection will kill most vegetative microorganisms, but will not kill the more resistant bacterial spores. Commonly used disinfectants, such as alcohol, iodophors, quaternary ammonium and phenolic compounds, are not effective sterilants and, therefore, are not acceptable for the use on items intended to be used in survival surgical procedures. For items which are unable to withstand high temperatures and pressure, ethylene oxide gas is the preferred method of sterilization. However, cold chemical sterilization may be used effectively for many items. These units only sterilize the tip of instruments.
All materials sterilized by ethylene oxide require safe airing time.
The use of chemicals classified as sterilants. Those classified as disinfectants are not adequate. It must be relatively smooth, impervious to moisture, and be a shape that permits all surfaces to be exposed to the chemical sterilant. All surface, both interior and exterior, must be exposed to the sterilant. Tubing must be completely filled and the materials to be sterilized must be clean and arranged to assure total immersion.