We use sterilization pouches with “built-in” internal indicators. Do we still need separate internal monitoring strips?

Most self-seal sterilization pouch brands, including MicroCare ProView® plus pouches, now feature built-in external and “internal” indicators. Technically this may be adequate for small pouches with a few instruments. But the “built-in” indicator cannot monitor adequate steam penetration inside instrument cassettes or thick surgery packs that are processed inside self-seal pouches. Therefore it is recommended that a separate internal monitoring strip be placed inside the cassette or pack prior to packaging and sterilization. ProChek ID strips (SM4340) may be used but ProChek S multi-parameter Class 4 integrators (TSI440) provide a higher level of assurance for this application.