Best Practices for Pass-Through Items in Sterile Processing Departments

Medical devices that are non-submersible, heat-sensitive (or both) pose a unique challenge for Sterile Processing Departments (SPDs) and often have less process standardization because standards and guidance do not offer clarity on the topic. These devices (commonly referred to as hand-wash-only or pass-through items) move from decontamination to the clean side of the department without automated washing or thermal disinfection. When this gap is not addressed, it can introduce workflow variability, increase exposure risk for staff, and compromise clean-side environments in ways that are easy to overlook.

What Are “Pass-Through” Medical Devices?

Pass-through items are reusable, non-submersible or heat-sensitive, critical or semi-critical, medical devices that cannot be processed in automated washers or be subject to thermal disinfection. These medical devices are often transferred from decontamination to the clean side via a pass-through window or a drying cabinet.

Common examples include:

• Cameras and lensed devices
• Select rigid endoscopes
• Handheld power equipment
• Batteries and battery-powered components
• Cords and cables

These devices often contain sensitive electronics, optics, adhesives, or coatings that restrict immersion and/or heat exposure. Pass-through items still require sterilization or high-level disinfection later in the workflow, and many are sterilized in a low-temperature sterilizer using Vaporized Hydrogen Peroxide. But are they safe to handle before they're sterilized?

Challenges Associated with Heat-Sensitive and Non-Submersible (Pass-Through) Devices

When reprocessing medical devices, most reusable instruments follow a clearly defined path: point-of-use treatment, manual cleaning, automated washing, thermal disinfection, inspection, assembly/packaging, and sterilization. By definition, hand-wash-only devices do not fit neatly into this model. They are frequently classified as critical or semi-critical devices, yet they must bypass the automated systems that provide a validated, repeatable microbial reduction step.

STERIS conducted an informal survey to understand current methods for manually cleaning heat-sensitive and non-submersible devices. We found various unvalidated methods, such as:

General surface disinfectant wipe or spray

Alcohol wipe or alcohol with non-linting cloth

Enzymatic detergent and lint-free cloth

Sterile water / Rinse Only

A common and well-intentioned workaround is the use of environmental surface sprays or wipes. While these products are effective on non-porous environmental surfaces and are EPA-registered, they are not validated for reusable critical and semi-critical medical devices with complex materials and downstream sterilization requirements.

This workaround introduces uncertainty around material compatibility, residue, and whether the disinfection step itself was successful.

A Validated Process to Disinfect Pass-Through Devices

Today, PROLYSTICA™ Pass-Thru Disinfectant Wipes deliver the first and only cleared and validated cleaning + intermediate-level disinfection product in a single step. Intermediate-level disinfection renders devices safe to handle during assembly/packaging on the clean side. When implemented according to their instructions for use, these device wipes provide standardized intermediate-level disinfection designed for this specific hand-wash workflow. This allows departments to move away from environmental surface products and toward a cleared and validated, device-intended process.

Designed specifically for non-submersible and/or heat-sensitive critical and semi-critical devices, the wipes feature a validated 3-minute contact and 10-second rinse time to enable fast, repeatable intermediate-level disinfection.

This standardized approach can significantly reduce the number of manual reprocessing steps, streamline workflows, and provide confidence that devices are safe to handle.

Rethinking Pass‑Through Device Disinfection

Pass-through items highlight a broader truth in some sterile processing departments: when validated solutions do not exist, workarounds can become the accepted routine.

Recognizing that this gap exists for non-submersible and/or heat-sensitive “pass-through” or “hand-wash only” items, and understanding the difference between environmental surface products compared to a validated medical device product, creates an opportunity to standardize a workflow that has long been overlooked.

By adopting a validated process designed specifically for medical devices, SPDs can reduce variability, lower exposure risk for staff, and strengthen compliance without disrupting downstream sterilization or high‑level disinfection processes.