Chironga Kudzai, Swanepoel Stefan, Dey Roopam, Graham Simon Matthew, Held Michael, Laubscher Maritz
Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa.
Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
Eur J Orthop Surg Traumatol. 2023 Jan;33(1):119-124. doi: 10.1007/s00590-021-03169-9. Epub 2021 Nov 24.
Cost-saving strategies are important, especially in a resource-constrained environment. One such strategy well supported in the literature is the reuse of temporary monolateral external fixator components, a strategy we utilize at our institution. The aim of the study was to determine the safety and cost saving associated with the reuse of definitive circular external fixator components in a resource-constrained environment.
We performed a retrospective review of all adult patients who were treated with either new or reused circular external fixators from a single manufacturer between January and December 2017. Reused circular external fixator components, excluding half pins and wires, were subjected to an in-house reprocessing protocol. Cost savings were calculated as the difference between the price of a completely new frame and the amount invoiced for new components only in a reused frame.
Thirty-three patients were included in the study with an average age of 31.9 years. The mean duration of treatment with a circular external fixator was 5.8 months. No mechanical failure events were recorded during the study period. Our institution saved approximately 52% (R717 503.89) and 63% (R136 568.19) of expected total cost for hexapod and Ilizarov frames, respectively.
The strategy of reusing circular external fixator components is unconventional, and this study was conducted to evaluate the safety and potential savings in a resource-constrained environment. We demonstrated this practice to be reasonably safe and to result in significant cost savings which might be relevant in low-and-middle-income countries.
成本节约策略很重要,尤其是在资源受限的环境中。文献中充分支持的一种此类策略是重复使用临时单侧外固定器组件,这是我们机构所采用的策略。本研究的目的是确定在资源受限环境中重复使用确定性环形外固定器组件的安全性和成本节约情况。
我们对2017年1月至12月间使用同一制造商生产的新的或重复使用的环形外固定器治疗的所有成年患者进行了回顾性研究。重复使用的环形外固定器组件(不包括半针和钢丝)按照内部再处理方案进行处理。成本节约计算为全新框架的价格与仅用于重复使用框架中的新组件开具发票金额之间的差值。
33名患者纳入研究,平均年龄31.9岁。环形外固定器的平均治疗时长为5.8个月。研究期间未记录到机械故障事件。我们机构分别节省了六足架和伊里扎洛夫架预期总成本的约52%(717 503.89兰特)和63%(136 568.19兰特)。
重复使用环形外固定器组件的策略是非传统的,本研究旨在评估在资源受限环境中的安全性和潜在节约情况。我们证明了这种做法相当安全,并能带来显著的成本节约,这在低收入和中等收入国家可能具有相关性。