O'Flynn P, Silva S, Kothari P, Persaud R
UCLH Head & Neck Centre, London, UK.
Ann R Coll Surg Engl. 2007 Sep;89(6):616-23. doi: 10.1308/003588407X205350.
Prions are resistant to conventional sterilisation procedures and, therefore, could be transmitted iatrogenically through re-usable adenoid and tonsil surgical instruments. Using disposable instruments would avoid the risk of transmission. We present the results of a complete audit loop using BBraun single-use surgical instruments (SUSI).
This was a prospective multicentre audit. Surgeons were asked to fill in a standardised questionnaire recording details including postoperative complications, and evaluation of each piece of equipment compared with their own experience of conventional re-usable instruments. In the first cycle, constructive criticisms of the instruments were noted and the manufacturers modified the instruments accordingly. A second cycle of audit was subsequently undertaken.
A total of 86 patients were audited in the first cycle and 97 in the second cycle. Postoperative haemorrhage rate for both cycles was well within acceptable range. In the first audit cycle, surgeons generally found the Draffin rods, Boyle-Davis gag and bipolar diathermy forceps of poor quality and difficult to use. These were redesigned and, on repeat evaluation during the second audit cycle, were found to be just as good, if not better, than the re-usable instruments.
This study suggests that SUSI may be just as good as re-usable instruments. Furthermore, they may be more cost effective.
朊病毒对传统消毒程序具有抗性,因此可能通过可重复使用的腺样体和扁桃体手术器械医源性传播。使用一次性器械可避免传播风险。我们展示了使用贝朗一次性手术器械(SUSI)进行完整审核循环的结果。
这是一项前瞻性多中心审核。要求外科医生填写一份标准化问卷,记录包括术后并发症等详细信息,并根据他们使用传统可重复使用器械的经验对每件设备进行评估。在第一个周期中,记录了对器械的建设性批评意见,制造商据此对器械进行了改进。随后进行了第二个审核周期。
第一个周期共审核了86例患者,第二个周期审核了97例。两个周期的术后出血率均在可接受范围内。在第一个审核周期中,外科医生普遍认为Draffin棒、博伊尔 - 戴维斯开口器和双极电凝镊质量差且难以使用。这些器械进行了重新设计,在第二个审核周期的重复评估中,发现它们即便不比可重复使用的器械更好,至少也一样好。
本研究表明一次性手术器械可能与可重复使用的器械一样好。此外,它们可能更具成本效益。