Regarding the efficiency of sterilization, 8% hydrogen peroxide (H₂O₂) plasma system is able to achieve the same 6-log microbial killing as ethanol oxide (650mg/m³, 55°C×3h) at 45°C for 28 minutes but with a cost of equipment transformation being 580,000 yuan/unit (only 120,000 yuan for conventional sterilization chamber). According to the Fresenius Medical 2023 data in Germany, energy demand on an annual basis after implementation of plasma technology increased by 37% (from 18kWh to 24.7kWh per sterilization), but expenses for waste elimination decreased by 63% (no toxic residues needed treatment).
In 30mg/L concentration and 70%RH humidity, the exposure time must be extended to 1.8 times (5.4h vs. 3h) of ethanol oxide, which results in a 41% decrease in the turnover of medical devices. The case of Telmo company in Japan shows that the replacement cost of the ozone system is only 85,000, and the life cycle carbon emissions are reduced by 79.34 million.
In the 35MPa pressure and 45°C condition, the sterilization process is shortened to 45 minutes (75% less than ethanol oxide), and the rate of precision electronic component damage lowers from 3.7% to 0.2%. The initial cost up to $2.2 million (pressure vessel and control system) limited its application in mid-sized healthcare institutions (payback period of 7.2 years).
Material compatibility varied by up to peracetic acid (CH COOOH), which impacted tensile strength in polycarbonate by 8.3% (ethanol oxide 2.1%), but for which greater clearing of biofilms was achieved at pH3.0 (clearing 98.7% vs 92.4%). A 2022 CDC study found that switching to peracetic acid increased endoscopic maintenance frequency by 23%, but reduced hospital-acquired infection rates by 0.8 percentage points (savings of $420,000 annually in infection control expenditures).
From an environmental perspective, the global warming potential (GWP) of the UV-C (UVC) system is only 0.3% ethanol oxide and does not leave chemical residue behind. The practical application is limited, however: the sterilization breakdown rate for sensitive instruments is 17% (areas in the shadows cannot be irradiated), which needs to be integrated with the robot positioning system (an additional $150,000 equipment expense). Getinge’s smart UV sterilizer uses a six-axis industrial robot to limit the failure rate to 3.2%, but the single sterilization cycle is 2.5 hours longer.
The technology maturity gradient is clear: Plasma technology has 487 FDA 510(k) cleared medical devices (2024 data), whereas scCO₂ technology has only 89 approvals. Incited by the EU MDR regulation, the market size of ethanol oxide replacement technology has increased 34% annually, but the replacement rate remains only 12.7% (Medical Sterilization Market Analysis Report 2023). The data indicate that in multi-objective optimization of sterilization efficiency (±8%), equipment cost (3-18x), environmental benefit (39-79% carbon emission reduction), there is no global advantage alternative.