When his staff discovered a tear in the sterile wrapping on the power tools he was scheduled to use for a total knee replacement, Thomas Ferro, MD, had 2 choices: wait a couple of hours for sterile processing to wash and resterilize the compromised tools or use the disposable saw and drill the hospital had in stock for just such occasions. He decided to give the single-use power tools a try. Within minutes, he was able to continue with the procedure. Much to his surprise and satisfaction, the saw had sufficient power and battery life to make very precise bone cuts.

"Though not quite at the level of their front-of-the-line, reusable counterparts, these disposable tools did the job just fine," says Dr. Ferro, the medical director of the Bone & Joint Center in Arroyo Grande, Calif. "I plan to have these tools as backup at every hospital I work in, specifically for situations like the one we encountered."

In addition to orthopedic power tools, manufacturers are now making equipment like colonoscopes, arthroscopes and bronchoscopes available as reusable options. Just as an orthopedic surgeon can unpack a sealed, disposable drill to perform a knee replacement, a gastroenterologist can discard a scope after a colonoscopy. We highlight a few examples on the pages that follow.

The case for one-and-done disposable surgical instruments gains more attention each year, as do concerns over the thoroughness of sterile reprocessing. Unlike reusable tools that are reused on hundreds of patients and reprocessed after each surgery, disposable tools are supplied to your facility clean, pre-sterilized and in a single-use format. Rather than replacing reusable instruments, single-use devices are intended to relieve instrument backlogs, which are common in busy reprocessing departments where it can be physically impossible to keep up with a day of multiple cases requiring the same instruments. Being able to count on ready, safe equipment every time could become the game changer in these facilities.

As is the case in any discussion of how to stock a surgical facility, the primary concern here is cost. Buying costlier single-use scopes or power drills when reusable devices still are the norm seems unconvincing at first. Plus, with the addition of increasing the weight of hazardous waste, disposal costs would inevitably increase for any facility wanting to make these single-use devices the primary resource.

"I would definitely need to see some cost-benefit analysis before making that kind of switch," says orthopedic surgeon and sports medicine specialist David Geier, MD, of Mount Pleasant, S.C. "The benefits don't seem to outweigh the costs, and sterile reprocessing these days is pretty thorough."

Indirectly, however, the idea behind going disposable could potentially save in other areas. Without the need to go through reprocessing, single-use colonoscopes, for example, which are notoriously difficult and cumbersome to reprocess, could save the average sterile processing department (SPD) much needed space, time and resources. SPDs are not revenue-generating departments, so the costs incurred by falling behind a high case volume and the converse savings secured by rapid turnover are difficult to quantify. OSM