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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

CMS to surveyors: ‘Flash sterilization’ dropped as outmoded, look for properly performed “immediate use” measures

The Centers for Medicare and Medicaid Services is advising its inspectors that the outmoded term “flash sterilization” has been largely dropped in medicine in favor of “Immediate Use Steam Sterilization” (IUSS), issuing a memorandum that goes beyond semantics by emphasizing that IUSS is a more rigorous process.

“The new IUSS term is still used to describe the process for steam sterilizing an instrument that is needed immediately, not intended to be stored for later use, and which allows for minimal or no drying after the sterilization cycle,” the CMS explained in an Aug. 29 memo . “IUSS is now the preferred term, because “flash” does not adequately convey the fact that sufficient time and a number of steps and safeguards are required to accomplish pre-cleaning procedures that are necessary to ensure sterilization. The old terminology is also not necessarily consistent with current recommendations for the length of cycles needed for IUSS and/or the need to use rigid sterilization containers designed specifically for IUSS.”

It should be noted that IUSS is not equivalent to “short cycle” sterilization, the CMS clarified. Regardless of the cycle duration, correct use of a sterilization cycle for a wrapped/contained load that meets the device manufacturer’s instructions for use is the equivalent of “terminal sterilization” and is not IUSS if it includes use of a dry time and is packaged in a wrap or rigid sterilization container intended to be stored for later use.

“Practices associated with the outmoded term ‘flash’ sterilization have been implicated in surgical site infections and are considered to pose an increased risk of complications because of potential barriers to thorough completion of all necessary reprocessing steps,” the CMS concluded. “IUSS also entails an increased risk of inadvertent contamination during transfer to the sterile field and damage to the instruments, as well as risks related to wet instruments and the potential for burns. Therefore use of IUSS, even when all steps are performed properly, should be limited to situations in which there is an urgent need and insufficient time to process an instrument by using terminal sterilization.”