The basic sterilizing cycle has changed little over many years, and the reliability of autoclaves is constantly improving. All have to comply with EN 285 and all the processes are now validated according to EN 554 (6,7). Where change has occurred, it was in response to legislative, regulatory and performance requirements introduced in recent years.
Assessment of sterilization is now performed systematically with the Bowie and Dick test, the analysis of the cycle record and class six  indicators. Data loggers used in each cycle now represent a more frequent alternative, associated or not with an electronic global traceability. The logbook contains all the elements leading to the load release, including the traceability of the steps of pre-disinfection and cleaning.
The high temperatures associated with steam can cause damage and lead to safety concerns. Most plastics cannot withstand high temperatures. Steam can corrode surgical alloys and cutting edges. Chrome stainless-steel surgical blades and other related devices have developed pitting and dulling of the cutting edges after multiple steam sterilization cycles. Low-temperature gas plasma is generally compatible with most materials used in medical devices (8). In Libyan healthcare settings, the use of steam continues to be the preferred and cost-effective medium for the sterilization of reusable medical devices.