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Game Changers in Surgery - June 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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J U N E 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 7 N obody throws away their retractors, chop- pers, hooks, forceps or phaco handpieces after completing a cataract case. Why in the world do some of us throw away our scalpels? With Diamatrix ProTekt multi-use safety knives, we don't have to, and we think that's better for our patients, our staff, our patients and our planet. Our three-doctor practice performs about 4,000 cataract procedures per year in our two ASCs. We do every one with resposable ProTekt Primary Incision knives and MVR-style Paracentesis knives. Here's why: • Most importantly, these knives are exquisitely sharp and create extraordinarily reproducible inci- sional architecture. The wounds self seal, virtually never requiring glue or a suture for a tight seal. • These knives incorporate an easy-to-use safety sheath that protects staff from sharps injuries and protects the blade from dings. • Each one is validated for up to 15 uses. So instead of purchasing around 8,000 scalpels during the year and paying for the associated medical waste costs, we purchase and dispose of only about 600 scalpels. That saves tens of thousands of dollars that we can put to better use. Disposable knife reps may tell you that passing a knife through corneal tissue and autoclaving dulls it. Perhaps that's true for knives that don't incorporate high-quality, hardened tempered steel, but it's not the case for Protekt. During the first few uses, Protekt knives penetrate tissue nearly as well as a diamond knife. They do start to dull after many uses, but that's not a problem. When the sur- geon senses that increased traction is necessary to make the wound, he or she can simply request a new knife. What about cross contamination? It's true that use of any instrument, including phaco handpieces, can result in tissue residue, aqueous, viscoelastic and blood collec- tion. But as long as your staff rinses the blade promptly after the case (we do it with the safety mechanism engaged) that material typically washes right off. If residue is stubborn, we can use an instrument wipe. In our practice, endophthalmitis and TASS are so rare as to be virtually non-existent at our center. We have gone more than 10,000 cases without a single incident. The savings that ProTekt scalpels afford us create eco- nomic space to try new things that benefit our patients. Currently we are planning to try injecting intracameral steroid/antibiotic medications at the end of each case to obviate the need for drops. That will cost money, but the savings we're achieving on scalpels helps make up for it. There is one downside. If we all use resposable scalpels, it will cut into the profit margins of disposable knife mak- ers. That's a shame, but it's a risk we're willing to take for better patient care, better staff safety, better economics and a little less trash in the landfill. Dr. Loden, a fellowship-trained anterior segment sur- geon, speaks nationally and internationally on cataract and corneal surgery. The Powerful Case for Reusable Scalpels They're better for patients, facilities and the environment. James Loden, MD, Nashville, Tennessee Sponsored by SPECIAL ADVERTISING SUPPLEMENT The author at work.

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