AIt is not necessary to double pouch everything. Most peel pouches have been validated for use as single pouches. As with everything it is essential that you always refer to and follow manufacturer’s instructions for use. The validation of single pouch use assures that, when packaged and used appropriately, the single pouch allows for the permeation of the sterilant into the package allowing for the sterilization of the contents. Packaging materials including peel pouches must also be validated for sterility maintenance. When using peel pouches appropriately for the proper size and weight of objects a single package should suffice. Some institutions double pouch a small array of select items to allow for sterile presentation onto a sterile field, e.g. for peel pouches that may contain several small pieces and the like. If you find that routine double pouching is necessary to prevent tearing and punctures you might want to assess packaging techniques, and consider the utilization of accessories such as tip protectors, which would be more effective and appropriate than double pouching. More importantly, you should evaluate the quality of the peel pouches you are utilizing. There are many different brands on the market and quality does vary amongst the different manufacturers. Packaging products must be purchased based on quality vs. price alone. Many hospitals that routinely double pouch are doing so because of the poor quality of the pouches they use. They may have purchased based on a lower price, but having to double pouch doubles their packaging cost. Double pouching could actually be an inferior practice in that the pouch utilized may not have been validated for a double pouching application and thus its performance could be questionable. While you think it might be a better barrier to contaminants, it might not be allowing adequate sterilant permeation. If you choose to use double pouching it is imperative that you get the appropriate documentation and validation from your manufacturer to do so. To my knowledge there currently is only one peel pouch manufacturer whose product has been validated for double pouching packaging. When you are double pouching there are specific packaging methods, techniques and size configurations that must be considered for the internal and external pouch.