VSP can be ETO-compatible when the bottom substrate includes a breathable component such as Tyvek or porous paper that allows ETO penetration. The top skin film must also be ETO-permeable or the ETO penetration must occur through the substrate alone. Standard hermetic skin films are not ETO-compatible and require gamma or e-beam sterilisation.

For many applications, yes — particularly when device geometry is complex, production volumes are moderate, or premium presentation is a priority. VSP eliminates the need for costly aluminium thermoforming tooling and accommodates design changes without tooling modification. However, for high-volume, simple-geometry devices, thermoforming typically offers lower per-unit cost.

The skin film is drawn directly to the device surface under vacuum, bonding it firmly to the bottom substrate with no cavity gap. This eliminates all device movement within the package, significantly reducing the risk of impact damage, abrasion of instrument tips, or loosening of assembled components during distribution — without requiring foam inserts or custom fixturing.

The most common substrates are coated paperboard (for display applications) and Tyvek-faced boards or cards (for ETO-compatible sterile barrier performance). Rigid PETG trays are also used as VSP substrates when additional structural support is required. All substrates must be validated for compatibility with the skin film and sterilisation method.

Opening validation assesses whether the trained end user can open the package and present the device without contaminating the sterile device or inner package surfaces. Typically evaluated using a human factors study with representative users under simulated use conditions. The peel force, film tear behaviour, and geometry of the peel tab are all considered in the design.