Foam is a biatch to sterilize. It doesn’t release moisture, so you can’t use the most common initial sterilization method, ethylene oxide; and you can’t use the most common re-sterilization methods, vaporous hydrogen peroxide and autoclave.
Inclusion of foam on a medical device guarantees that it will be single-use, so much so that manufacturers will include it as a way of enforcing single-use for a device that hospitals tend to resterilize.
It’s not impossible, but it means that the procedure pack will need to be gamma sterilized instead of EtO, which is more expensive, and the foam cutout would need to be tossed every time.
