Gelling powders were introduced about 15 years ago to address leaking and spilling risks associated with capping fluid-filled canisters. The powders turn the fluids into a gelatinous-like substance in about 5 to 10 minutes. But you'll find that solidifying fluid waste has the same drawbacks as capping, plus several unique drawbacks of its own. The most obvious is cost. In addition to the costs of the disposable canister, each dose of gelling powder runs $2 or more.

Solidifying is dose-dependent. You must judge the amount of agent needed to adequately gel the amount of fluid in each canister, a process that could lead to overdosing and wasting the gelling agent. But you also need to be concerned about underdosing, which can lead to leaking canisters.

Solidified fluid also adds significant weight to red bag waste — filled containers can weigh between 7 pounds and 35 pounds — of which it costs between 20 cents and 50 cents per pound to dispose.

Compared to manual pouring, capping and solidifying can more than triple the weight of OR infectious waste. That's a significant concern when you consider a typical OR can generate about 2 tons of fluid each month.

One final note about the use of solidifying agents: Suction canisters coming out of the OR can contain large whole blood clots. Most gelling agents that claim treatment of suction canister waste base their efficacy on blood serum testing only, and many of those products are not approved for the treatment of clots.

Closed fluid waste disposal systems essentially remove all risk of fluid exposure and risk of injury from moving filled suction canisters. Mobile collection carts, which are wheeled into ORs where fluid-producing cases are performed, attach directly to collection pouches on the surgical drapes, floor-wicking devices and fluid-retaining mats placed around the sterile field. The large-volume units have enough capacity to handle fluid runoff during multiple cases. When they're filled, a staff member wheels the easy-to-maneuver unit to a dedicated docking station, which automatically suctions the fluid contents directly into the sewer.

After discharge of the infectious liquids into the sanitary sewer, one system automatically cleans and disinfects the inside of the mobile carts with an enzymatic cleaner, surfactants and a U.S. EPA-approved disinfectant. After the cleaning and disinfection process, you can safely open the system, remove the fluid collection reservoirs for reuse and dispose of the system's disposable manifolds as general waste, which helps reduce red bag disposable expenses. The disinfecting cycle also ensures the reservoirs are clean and free of microbial pathogens before you wheel the system back to the next OR.

Wall-mounted disposal systems offer a more affordable option that eliminates risk of exposure to splashing and aerosolized fluid particles. You'll also avoid the added expenses of solidifying gel and disposing of solidified fluid in red bag waste.