• Matthew G Blake, Marissa Gracia, James Uregen, Elena Brown, Kenneth Romito, Christopher Stucky, Christy Mitchell, and Bethany Atwood.
• Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
• Mil Med. 2025 Jan 27.

IntroductionThe storage of reusable medical devices (RMDs) is the final reprocessing phase and the step that directly precedes point-of-care delivery. Reusable medical devices, including surgical tools necessitating sterilization and semicritical devices such as endoscopes, undergo high-level disinfection. The rigorous reprocessing protocols and subsequent storage of RMDs are crucial in preserving their sterility and asepsis. This ensures they are available, clean, and safe for patient use, thereby significantly reducing the risk of surgical site infection. The stringent requirements for RMD storage are a testament to the critical role it plays in patient safety, making it a demanding task for health care organizations (HCOs) to comply with. These challenges are further amplified in austere environments. This integrative review aims to identify optimal storage practices, emphasize the critical importance of RMD storage in the Military Health System, and derive implications for policies and future considerations.Materials And MethodsThe authors performed an integrative review and comprehensive literature search in PubMed/MEDLINE, CINAHL, and Embase using the keywords "instrument storage," "surgical instruments," "sterile storage," "sterile wrap," and "flexible endoscope storage." Articles were limited to English from 1980 to 2024. Additionally, the authors reviewed international guidelines to support RMD storage.ResultsThe integrative review of 42 articles and 14 guidelines and articles identified 6 central themes supporting RMD storage, which include facility design, environmental considerations, sterile storage packaging systems, considerations for event-related sterile storage, point-of-care delivery, and endoscope storage best practices. The abundance of evidence-based recommendations and guidelines complicates adherence to optimal practices in HCOs, presenting significant challenges in austere environments. Integrating RMD storage considerations into training, exercises, and operations help promote a culture of RMD stewardship to ensure safe surgical and procedural care within the Military Health System.ConclusionAlthough surgical teams' capabilities are crucial in delivering effective care in a dynamic environment, the management and storage of RMDs are equally essential. Numerous organizations have outlined rigorous guidelines for HCOs to comply with, which can be intensified in austere conditions. Ultimately, a commitment to integrating the literature and developing the groundwork for clinical practice guidelines can improve the safe storage of RMDs in both standard and austere environments.© The Association of Military Surgeons of the United States 2025. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.

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