Flexible nasoendoscopy decontamination: a comparison between Rapicide and Tristel wipes, a prospective cohort study


  • Yijin Jereme Gan Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore
  • Alex Mathews Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore
  • Phua Chuqin Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore
  • Ivan Khoo Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore
  • David Loke Department of Otolaryngology, Khoo Teck Puat Hospital, Singapore




Nasoendoscope, Decontamination, Tristel wipes, Peracetic acid, Rapicide


Background: The current disinfection of nasoendoscopes in our clinic setting is a 3-step process involving Rapicide, a peracetic acid based disinfectant. Our study aimed to validate the efficacy of Tristel wipes, a chlorine dioxide based disinfectant, as a comparable alternative.

Methods: We recruited a hundred volunteers undergoing routine flexible nasoendoscopic examinations in a general ENT. We used two separate endoscopes for each examination, following which a microbiological swab was sent from the tip of each nasoendoscope. The two nasoendoscopes were then subjected to a similar 3-step decontamination process except for the second step, where they were disinfected either tristel wipes or rapicide disinfectant. After decontamination, we took a second swab from the tip of each nasoendoscope.  

Results: Out of 200 swabs from the tip of the nasoendoscopes prior to decontamination, there were 82 positive cultures for the Rapicide cohort and 76 positive cultures for the Tristel wipes cohort. Regarding the post decontamination results, there were four positive swab cultures for those disinfected with Tristel wipes and one positive swab culture for the Rapicide cohort. These were analyzed by the Z score and there was no statistical difference between either the pre-decontamination swabs or the post decontaminations swabs with the p-values at p=0.298 and p=0.174 respectively. The efficacy of decontamination for the Rapicide solution was 98.8% compared to 94.7% for the Tristel wipes with p=0.147.

Conclusions:This study validates the efficacy of Tristel wipes as a comparable alternative to peracetic acid based disinfectants for disinfection of flexible nasoendoscopes.



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Original Research Articles