Extract
In response to increasing environmental and economic pressure, the reuse of
single-use devices has become more prevalent in the United States. Managed
care and Medicare have reduced reimbursements in the past decade, and annual
surgical waste from common operations of the back, knee, and hip has increased
to a reported weight of 1.84 × 107 lb (8.3 ×
106 kg) and a volume of 5 × 106 ft3
(1.42 ×
105m3)1,2.
Consequently, hospitals and surgery centers have sought to cut expenditures
and reduce the amount of surgical waste produced. One method that a quarter of
the hospitals in the United States have begun to use is the reuse of
disposable surgical equipment. Studies involving angioplasty balloons, cardiac
catheterization wires, trocars for laparoscopic surgery, cytology brushes for
bronchoscopic sampling, surgical draping, and endoscopic equipment have all
been evaluated to see whether use of reprocessed single-use devices is
efficacious, cost-effective, and environmentally
sound3-5.
The majority of studies on the cost-effectiveness and efficacy of reprocessed
single-use devices have been on endoscopy equipment. Wilcox reported, in 2000,
that it was both financially and environmentally sound to use reprocessed
single-use devices for endoscopic surgery, and subsequent studies have
confirmed these
findings3. Another
recent study has revealed a substantial economic advantage in the reuse of
pacemakers without any appreciable risk of
infection6,7.
At the time of writing, we knew of no published report evaluating the quality
of reused single-use devices in orthopaedic surgery. The present paper
presents information regarding the current regulations and standards governing
the reuse of single-use devices.