Improving? standards, improving? surgery

The use of individually wrapped presterilized small orthopaedic implants increase operating time: a prospective experimental study

“…We have confirmed previous concerns 5 that the use of individually wrapped presterilized small orthopaedic implants can add to operating time. Certainly, such delays have to be taken into account especially when implants are used in complex fracture fixation, especially when the use of a tourniquet may impose time constraints.…”

“…General, cardiac, vascular surgical implantable items have been purchased presterilized and the batch number has been recorded in a patient's notes at the time of surgery. 1 Various orthopaedic prostheses such as joint replacements are already provided to us in such a fashion, 5 allowing the tracking of manufacturer or sterilization issues from production to patient. 2 …”

“…13 Furthermore, any issues of failure of sterilization and metallurgical faults of presterilized individually wrapped items when identified by the manufacturer may be more easily dealt in view of easier traceability. 5 …”

“…However, the use of individually sterilized prepackaged implants has already raised concern among orthopaedic surgeons in view of perceived increases in operation times and the lack of clinical evidence with regard to reducing harm to the patient. 5 We have quantified such potential increases in operating time using simulated scenarios.…”

Improving patient outcomes

“…In his letter published in this issue of ANZ Journal of Surgery , Dr Brydon refers to significant practical problems in orthopaedic trauma surgery with the introduction of recommendations made in AS4187‐2003 1 . He concludes the problems to be a major deleterious effect on the surgeon with no benefit to patient safety.…”