What is the most common reason for steam sterilization failure?

The most common reason for steam sterilization failure is the lack of steam contact with the instrument. For sterilization to be effective, steam must come into direct contact with all surfaces of the items being sterilized. If there is any barrier preventing steam from reaching these surfaces—such as wraps that are too thick, improper loading of the sterilizer, or the presence of air pockets—sterilization will not occur properly. This can lead to viable microorganisms remaining on the instruments, which poses a risk of infection when the instruments are subsequently used.

In contrast, while inadequate sterilization time and excessive load can contribute to sterilization failure, they are often secondary issues. An insufficient sterilization time may not allow for proper microbial kill if conditions are correctly maintained otherwise. An excessive load can also hinder the circulation of steam, but the fundamental issue of ensuring that steam makes contact with all surfaces remains paramount. Proper training is relevant to ensuring the process is followed correctly, but it does not directly address the physical interaction necessary for effective sterilization.