This article by Collins is a review of the English-language medical literature on reprocessing flexible nasopharyngoscopes. The aim of the review was to identify the steps critical to effective reprocessing.
In summarizing the reviewed literature, Collins noted that high-level disinfection has been determined to be the minimum level of disinfection required for reprocessing of flexible nasopharyngoscopes, but that traditional high-level reprocessing requires strict adherence to recommended procedures and that the risks of human error and device failure must be recognized. According to Collins, all effective reprocessing techniques include manual cleaning, leak testing, cleaning with an enzymatic agent, high-level disinfection, and drying with vertical storage. The author commented, however, that three methods for achieving high level disinfection are available: manual disinfection with a liquid disinfectant or sterilant, use of an automated reprocessor, and use of a disposable sheath during the endoscopic procedure.
With respect to EndoSheath® Technology (Vision Sciences, Medtronic, Jacksonville, FL), Collins said that his otolaryngology literature review found that no defects in these devices have been reported; that flexible nasopharyngoscopes used with disposable sheaths still require mechanical cleaning, application of an enzymatic agent, and wiping with 70% ethanol; and that the barrier provided by EndoSheath® Technology has been tested down to 27 nm, the same size as the smallest infective human virus (poliovirus).
