High-level disinfection of endoscopes: the steps

Endoscopes contact mucous membranes and cannot be processed with high heat. High-level disinfection (HLD) with chemical agents in a strict sequence is therefore used.

Reprocessing steps

• Pre-clean immediately after the procedure to remove organic soil;
• Leak test;
• Manual or automated cleaning with an enzymatic agent, including channels;
• High-level disinfection with an agent of confirmed activity;
• Rinse with clean (ideally sterile) water;
• Dry the channels and outer surfaces;
• Store in conditions that prevent recontamination.

Why cleaning before HLD matters

Biofilm and organic residues shield microorganisms from the disinfectant. Without proper pre-cleaning, even an effective agent will not work — cleaning and HLD work only together.

Quality control

Correct concentration, contact time and solution temperature are critical. Keeping reprocessing logs and using control tools makes the process reproducible.