Biofilm Formation During Reprocessing of Reusable Medical Devices and Strategies for Its Elimination

Device-Associated Infections (DAIs) represent a significant global challenge to healthcare safety, and the formation of biofilms is widely recognized as one of their core pathogenic mechanisms. Throughout the entire process of cleaning, disinfection, and sterilization of medical devices (i.e., reprocessing), improper operation or procedural deficiencies may allow residual organic matter and microorganisms to adhere to device surfaces and rapidly develop into highly resistant biofilms. These biofilms act as persistent “hidden contamination sources,” posing serious threats to patient safety. This paper systematically elaborates on the fundamental concepts and formation mechanisms of biofilms, as well as their dynamic evolution during each stage of medical device reprocessing (pre-treatment, cleaning, disinfection, sterilization, and drying/storage). It further analyzes key risk factors contributing to biofilm formation within current reprocessing workflows and comprehensively reviews recent advances and practical applications of physical, chemical, and emerging biofilm removal strategies. The aim of this study is to provide theoretical support and practical guidance for optimizing medical device reprocessing procedures, enhancing infection control, and safeguarding patient safety.