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INFECTION CONTROL
Hidden threat in operating theatres
The Clinical Services Journal speaks to Single Use Surgical – a company that was established as a response to UK hospitals’ concerns over cleaning practices – to find out why they champion single-use alternatives to reusable instruments.
In 2015, a multi-centre Lumen Inspection Survey inspected instruments from 71 hospitals in the US and revealed that 70% of instruments were classified as ‘dirty’, with suction tubes being one of the highest percentage instrument categories to fail inspection. Among the foreign matter found on the instruments included blood, bone, brush fibres and human hair.
He pointed out that UK hospitals have also identified that fine lumen suction tubes used in surgery pose a high risk of patient-to- patient cross infection due to them being too difficult to clean. Surgical instruments such as cannulae have narrow channels and sharp bends that are extremely difficult to clean and a result, debris will often linger that is invisible to the human eye. To address this issue, the company has worked closely with surgeons to develop single-use equivalents. “Reusing surgical instruments poses an increased risk of patient-to-patient cross- infection,” said Michael Denver, export manager at Single Use Surgical. “It is a hidden threat in the operating theatre and Single Use Surgical was established to tackle this issue.” “Even a tiny particle of debris can make the sterilisation process ineffective,” Michael Denver continued. “Instruments that are not 100% clean carry a risk of patient-to-patient cross-infection, from localised reactions to significant disease transmission. Therefore, switching to a single-use cannula protects patients from the risk of infection.” The company points out that it can also save time as the time required to reprocess surgical instruments is frequently underestimated, especially when extra time must be allocated to attempt to clean fine cannula. Other factors that consume valuable sterile services and clinical time include tracking and tracing instruments, counting and checking trays, postponed surgeries caused by lost or damaged devices and the repair of instruments. Over the years, there have been many health advisory notices to support the use of single-use surgical instruments over their reusable counterparts.
FEBRUARY 2017
“A case that comes to mind is that of John
Harrison. A 63-year-old Texan who experienced severe complications two weeks after what should have been a routine operation on his shoulder,” commented Michael Denver. “During emergency surgery doctors discovered that Harrison had been infected with
P.aeruginosa, a potentially lethal bacterium that had eaten away part
Switching to a single-use cannula protects patients from the risk of infection.
of the bone in his shoulder and rotator cuff.” Unfortunately this wasn’t an isolated incident; Harrison was one of seven joint surgery patients who had also contracted infections. This outbreak stimulated the hospital and the Centers for Disease Control and Prevention (CDC) to launch an inquiry into how the bacteria had survived the cleaning and sterilisation process. The results revealed that there were two likely sources of the infection; from an arthroscopic shaver, a power tool used to shave away bone; and the inside of a long narrow cannula used for irrigation and suction of the surgical site. As part of the investigation, they also inspected areas of these surgical instruments that are invisible to the naked eye using
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