Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Perioperative Services, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2019 Jan;233:32-35. doi: 10.1016/j.jss.2018.06.063. Epub 2018 Jul 27.
Right-sizing instrument trays reduce processing and replacement costs, physical strain, and turnover times. Historically, a 98-instrument head and neck tray has been used for breast lumpectomy cases at our institution. Observations revealed that many instruments on the tray were not used during the breast cases. With the significant number of surgical breast lumpectomies performed annually, tray downsizing could significantly reduce costs and physical strain.
Surgical technicians identified instruments needed for a standard breast lumpectomy. Breast surgeons reviewed the list and made final recommendations. Three of 13 existing head and neck trays were converted to breast lumpectomy trays. The number of breast lumpectomies in 2017 was pulled from the institution's health information system. Instrument quantities were verified using instrument management software. Weights were taken on a digital scale, and processing cost was estimated by a consultant.
The new breast trays included 51 instruments rather than the standard 98-instrument trays. Reprocessing cost decreased from $49.98 to $26.01. With 449 breast lumpectomies performed at the institution in 2017, the annual reprocessing savings totaled $10,763. The tray weight was reduced from 27 to 16 pounds. Setup time decreased from 7 to 4 min per use (22.5 h saved annually).
Downsizing from a head and neck tray to a specific breast lumpectomy tray demonstrated a reduction in reprocessing cost, tray weight, and setup time. Lighter trays allow for safer handling and transport by surgical personnel. In the current health-care environment, it is important to maximize operating room efficiency and minimize cost.
调整器械托盘的大小可以降低处理和更换成本、减轻体力消耗并缩短手术器械交接时间。在我们医院，历史上一直使用一个包含 98 件器械的头颈部托盘来进行乳房肿瘤切除术。观察发现，托盘上的许多器械在乳房手术中并未使用。由于每年进行的乳房肿瘤切除术数量众多，因此缩小托盘尺寸可以显著降低成本和体力消耗。
手术室技术员确定进行标准乳房肿瘤切除术所需的器械。乳房外科医生审查了清单并提出了最终建议。将三个头颈部托盘中的三个转换为乳房肿瘤切除术托盘。从医院的健康信息系统中提取 2017 年乳房肿瘤切除术的数量。使用器械管理软件验证器械数量。我们在电子秤上称重，并由顾问估算处理成本。
新的乳房托盘包含 51 件器械，而不是标准的 98 件器械托盘。重新处理成本从 49.98 美元降至 26.01 美元。2017 年，该机构共进行了 449 例乳房肿瘤切除术，每年的重新处理节省费用总计为 10763 美元。托盘重量从 27 磅降至 16 磅。每次使用的设置时间从 7 分钟减少到 4 分钟（每年节省 22.5 小时）。
将头颈部托盘缩小为特定的乳房肿瘤切除术托盘可降低重新处理成本、托盘重量和设置时间。更轻的托盘可让手术室人员更安全地处理和搬运。在当前的医疗保健环境下，最大限度地提高手术室效率和降低成本非常重要。
