One of the risks associated with inadequate pre-cleaning is the formation of biofilm. A biofilm is a “biological film” that is created when microorganisms adhere to a surface and bind together in a matrix, a thick and sticky substance.
Biofilms form on many types of materials, but particularly those that remain moist like the internal channels of a surgical instrument. The protective gel of the biofilm matrix prevents the penetration of most detergents, disinfectants, and sterilants, allowing microbial life inside the biofilm to survive the reprocessing process.
When the biofilm matures, it will release free floating cells from the biofilm, depositing microorganisms in its surrounding environment and potentially into the patient.
Once a biofilm has formed and adhered to the surgical instrument, it can be very difficult to remove in the cleaning process, particularly inside instrument channels.
Once biofilms have formed, standard cleaning procedures may not be adequate to remove them. An example from everyday life is dental plaque, which cannot be easily brushed off during normal hygiene.
Detecting biofilm is also a challenge, since many times it will not be detectable or visible to the naked eye until the biofilm has matured and multiplied in extreme cases. The best strategy to combat biofilm is to prevent their formation by removing gross soil and flushing cannulas at the point of use.