The Drying of Flexible Endoscopes

The drying of endoscopes is a crucial step often underestimated in its significance, yet it is just as vital as the preceding reprocessing steps. It has been well documented that wet endoscope channels in storage lead to expedited bacterial growth, and drying these channels significantly limits the outgrowth of bacteria [1].

Various drying methods are available, varying greatly by region and clinical administration. For instance, a hardline difference in approach is whether an alcohol flush is utilized. There are certain advantages to using alcohol as an additional bactericidal step, and drawbacks due to its nature of fixing proteins to medical equipment.

Gain more insights and find here a summary of the latest references to the scientific evaluation of real-world drying modalities in endoscopy units. Where several approaches were examined on their ability to eliminate residual moisture, largely divided into alcohol flush utilization or not, and ambient vertical storage versus a forced air-drying system.

  1. Alfa MJ, Singh H. Impact of wet storage and other factors on biofilm formation and contamination of patient-ready endoscopes: a narrative review. Gastrointest Endosc. 2020 Feb;91(2):236-247. doi: 10.1016/j.gie.2019.08.043. Epub 2019 Sep 12. PMID: 31521779.

  2. Perumpail RB, Marya NB, McGinty BL, Muthusamy VR. Endoscope reprocessing: Comparison of drying effectiveness and microbial levels with an automated drying and storage cabinet with forced filtered air and a standard storage cabinet. Am J Infect Control. 2019 Sep;47(9):1083-1089. doi: 10.1016/j.ajic.2019.02.016. Epub 2019 Apr 6. PMID: 30962022.

  3. Nerandzic M, Antloga K, Litto C, Robinson N. Efficacy of flexible endoscope drying using novel endoscope test articles that allow direct visualization of the internal channel systems. Am J Infect Control. 2021 May;49(5):614-621. doi: 10.1016/j.ajic.2020.08.034. Epub 2020 Sep 3. PMID: 32890550.

  4. Nerandzic M, Antloga K, Robinson N. Alcohol flush does not aid in endoscope channel drying but may serve as an adjunctive microbiocidal measure: A new take on an old assumption. Am J Infect Control. 2023 Jul;51(7):772-778. doi: 10.1016/j.ajic.2022.09.020. Epub 2022 Sep 18. PMID: 36130627.

  5. Yassin M, Clifford A, Dixon H, Donskey CJ. How effective are the alcohol flush and drying cycles of automated endoscope reprocessors? Stripped endoscope model. Am J Infect Control. 2023 May;51(5):527-532. doi: 10.1016/j.ajic.2023.02.008. Epub 2023 Feb 25. PMID: 36842713.

  6. Ofstead CL, Hopkins KM, Preston AL, James CY, Holdsworth JE, Smart AG, Lamb LA, Love KL. Fluid retention in endoscopes: A real-world study on drying effectiveness. Am J Infect Control. 2024 Feb 24:S0196-6553(24)00103-2. doi: 10.1016/j.ajic.2024.02.015. Epub ahead of print. PMID: 38408542.