Sterilization of 20 billion medical devices by ethylene oxide (ETO): Consequences of ETO closures and alternative sterilization technologies/solutions.

Background: To prevent healthcare-associated infections, it is essential that critical medical devices be sterilized before use. Although there are several sterilization technologies for medical devices, only ethylene oxide (ETO) sterilization has virtually universal material compatibility.

Methods: We searched the published English literature (Google, Google scholar and PubMed) for articles on the sterilization of medical devices by ethylene oxide, the consequences of ETO closures, and alternative sterilization technologies/solutions.

Results: ETO's compatibility and effectiveness with medical products allows for sterilization of many medical devices that would otherwise be rendered ineffective or unsafe if sterilized with an alternative method.

Conclusions: At present, there are no alternatives to ETO that provide the same sterility assurance and result in the same device performance as ETO; therefore, it is likely irreplaceable for years.