Pretreatment Best Practices: Building your best case scenario


For better reprocessing outcomes

UnderstandAdhering to best practices is second nature to Sterile Processing personnel, just like driving to work or reciting their own phone number. However, when it comes to pretreatment, even standards like ST79 are somewhat vague, leaving facility's responsible for determining the version of best practices to implement based on available information. At Case Medical, we’ve had a number of recent conversations with customers trying to puzzle through point of use care guidance. Here’s what our experts have to say.

Begin with ANSI/AAMI ST79

ANSI AAMI ST79-1When approaching pretreatment, we can begin with the stated purpose, according to ANSI/AAMI ST79, “Gross soil should be removed as soon as possible to a) Reduce levels of microorganisms and soil; b) Prevent soil drying; c) Reduce risk of biofilm development…” The table below lists a view of the relative effectiveness of water, non-enzymatic detergent, and enzymatic detergent at accomplishing the three stated purposes of pretreatment.





Non-Enzymatic Detergent

Enzymatic Detergent

a) Reduce levels of microorganisms and soil

Marginally effective

Moderately effective, surfactants lift soil from the surface

Highly effective, surfactants lift soil from the surface and enzymes break down various soil types

b) Prevent soil drying




c) Reduce risk of biofilm development

Marginally effective*

More effective*

Highly effective*

*Must be followed by decontamination within the prescribed time frame

Case Medical’s SuperNova® and Case Solutions® cleaners, lubricant and pre-cleaners meet the ANSI/AAMI guidelines definition of ideal cleaning agents and are U.S. EPA SaferChoice® awarded. PentaPrep® spray and foam is a multi-enzymatic pretreatment that helps maintain moisture on soiled instruments and CasePrep® spray and foam is a non-enzymatic alternative.

For endoscopes, follow with Multisociety Guidelines

Case Solutions Endoscope Bedside Kit

For endoscope reprocessing, the Multisociety Guidelines specify that, “Point of use precleaning should remove visible debris by wiping the exterior of the endoscope with appropriate detergent solution and aspiration of a large volume of detergent solution through the air/water and biopsy channels.” Case Solutions® Endoscope Bedside Kit is ideal for use at patient’s bedside, effectively reducing bioburden in preparation for transfer and additional cleaning steps.

Don’t wait! The clock is ticking

Olympus specifies that 60 minutes is the maximum delay between precleaning of their endoscopes at bedside and the start of manual cleaning. In addition, “all efforts should be made to decrease the amount of time that lapses between reprocessing steps as much as possible.”

Best case scenario for pretreatment

When manufacturers develop and validate reprocessing instructions for their devices, they test using worst case scenarios. This can mean using water instead of detergent or enzymatic solutions for their validation testing. However, the opportuIISaferChoice_DfE_RGB-1nity exists for users to do even better and create a best case scenario for the best reprocessing outcome.

Case Medical, a Safer Choice awarded developer and formulator of cleaners for instrument processing, provides pretreatment options so you can choose what is most suitable for your facility, your instruments, and your policies. All are pH neutral cleaners, and most incorporate a cocktail of synergistic enzymes to digest and remove organic matter. They offer the broadest material compatibility, are free rinsing, and are safer than other products in this category.

  • PentaPrep Multi-Enzymatic Pre-SoakCase Solutions® Beside Endoscope Kits – Perfectly proportioned pack of three disposable Penta Wipes and 250 ml of PentaZyme® Multi-Enzymatic Solution, ready to go immediately following an endoscopic procedure
  • PentaPrep® Multi-Enzymatic Pre-Soak – Excellent coverage with a range of enzymes to begin breaking down any residual soil
  • Penta Wipes® Multi-Enzymatic Surface Cleaning Wipes – Non-linting, disposable wipes with the power of enzymes for equipment, counters, containers, or instruments
  • CasePrep® Non-Enzymatic Pre-Soak – Excellent alternative with cleaning power for facilities that choose not to use enzymes

Join Case Medical in providing safer options for patients and staff.  Share your plan to build a “best case scenario” for pretreatment, for sustainability and better patient outcomes.