Water is important in all stages of medical device reprocessing. In fact, water is required for each step in the decontamination process, from soaking to manual or automated cleaning to rinsing, including the final disinfecting rinse. Furthermore, even concentrated instrument cleaners are composed primarily of water, the solvent for all chemicals in the solution.

Water that is safe to drink may not be acceptable for reprocessing or for sterilizing surgical devices. Water quality varies from place to place and according to the season of the year. Most public water systems include additives such as chlorine, dissolved salts and sometimes significant naturally occurring mineral content, and even organic contaminants, bacteria and endotoxins. Depending on water hardness and temperature, fresh water used can lead to the formation of hard water deposits, a layer of lime or scale that is difficult to dissolve.

In recent years, there has been growing awareness about the importance of water in the decontamination of surgical devices and the harmful effects of even minute quantities of contaminants on patients. This is of particular concern because certain medical devices may introduce contaminants directly into the body that are normally protected by skin and mucous membranes. Metals, organic compounds, microorganisms and pyrogens can lead to adverse reactions. Furthermore patients are particularly susceptible when surgical instruments bypass the body’s defenses.