Literature DB >> 33731215

Safety and cost-effectiveness of single-use endolaser probe reprocessing in vitreoretinal surgery.

Leandro Cabral Zacharias1, Lívia da Silva Conci2, Bianca Partezani Megnis2, Janaina Guerra Falabretti2, Taurino Dos Santos Rodrigues Neto2, Epitácio Dias da Silva Neto2, Rony Carlos Preti2, Leonardo Proveti Cunha2, Mário Luiz Ribeiro Monteiro2.   

Abstract

BACKGROUND: Endolaser probes have been designed and sold for single-use only. However, in Brazil, they are not included in the list of single-use medical products that are prohibited from being reprocessed and could potentially be reused if safety requirements are accomplished. Therefore, this study aimed to determine and compare the quality, safety and costs of reprocessed versus original single-use endolaser probes of a specific brand and model.
METHODS: The study, conducted at a university hospital in Sao Paulo, Brazil, was divided in two phases. The first one tested the feasibility, sterility and physical integrity of ten reprocessed laser probes. In the second phase, all vitrectomy procedures using endolaser probes (reprocessed and original ones) from August 2017 to October 2019 were evaluated. The operated cases were followed for any signs of infection and number of defective probes for each group were counted. The cost of acquiring a new probe and for all reprocessing stages were evaluated and quantified in US dollars($).
RESULTS: Microbiologic, residual ethilen oxide and microscopic evaluation of integrity of reprocessed laser probes were all within acceptable range. The second phase of this study included 590 endolaser probes, of which 375 were original and 215 were reprocessed. Functionality rates differed significantly between groups. Among the original probes, 373 (99.47%) were functioning and 2 (0.53%) were non-functioning. Among the reprocessed ones, 201 (93.5%) were functioning and 14 (6.5%) were non-functioning (p < .001). The average cost of one reprocessing was $3.00, and the average cost of an original probe was $150.00. Considering the loss rates, potential savings were $147.60 for each once-reprocessed probe. The frequency of infectious endophthalmitis was null in both groups.
CONCLUSIONS: Our study showed that a single cycle endolaser probe reprocessing was safe and efficient, not associated with increase in endophthalmitis rate and proved to be significantly cost-effective, even considering a greater malfunction rate when compared to the original devices.

Entities:  

Keywords:  Cost–Benefit Analysis; Laser Coagulation; Sterilization; Vitrectomy

Year:  2021        PMID: 33731215      PMCID: PMC7968303          DOI: 10.1186/s40942-021-00292-x

Source DB:  PubMed          Journal:  Int J Retina Vitreous        ISSN: 2056-9920


  11 in total

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Journal:  Rev Esc Enferm USP       Date:  2011-12       Impact factor: 1.086

2.  [Evaluation of microbial growth on single-use vitrectomy probes reprocessed in healthcare practice].

Authors:  Flávia Morais Gomes Pinto; Valéria Garcia Lopes Araújo; Rafael Queiroz de Souza; Vânia Regina Goveia; Carmen Castilho Missali; Reginaldo Adalberto de Luz; Kazuko Uchikawa Graziano
Journal:  Rev Esc Enferm USP       Date:  2012-06       Impact factor: 1.086

Review 3.  Review of thresholds and recommendations for revised exposure limits for laser and optical radiation for thermally induced retinal injury.

Authors:  Karl Schulmeister; Bruce E Stuck; David J Lund; David H Sliney
Journal:  Health Phys       Date:  2011-02       Impact factor: 1.316

4.  Presumed Sterile Endophthalmitis Afer Intravitreal Triamcinolone (Kenalog)-More Common and Less Benign Than We Thought?

Authors:  Angie H C Fong; Carmen K M Chan
Journal:  Asia Pac J Ophthalmol (Phila)       Date:  2017 Jan-Feb

Review 5.  Guidelines for the cleaning and sterilization of intraocular surgical instruments.

Authors:  David F Chang; Nick Mamalis
Journal:  J Cataract Refract Surg       Date:  2018-06-13       Impact factor: 3.351

6.  INCIDENCE OF ENDOPHTHALMITIS AFTER VITRECTOMY: A Systematic Review and Meta-analysis.

Authors:  Guohai Chen; Radouil Tzekov; Wensheng Li; Fangzheng Jiang; Sihong Mao; Yuhua Tong
Journal:  Retina       Date:  2019-05       Impact factor: 4.256

7.  Diode endolaser photocoagulation.

Authors:  W E Smiddy
Journal:  Arch Ophthalmol       Date:  1992-08

8.  Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group.

Authors: 
Journal:  Arch Ophthalmol       Date:  1995-12

9.  Endophthalmitis after pars plana vitrectomy with reused single-use devices: a 13-year retrospective study.

Authors:  Sukhum Silpa-Archa; Kwanchanoke Kumsiang; Janine M Preble
Journal:  Int J Retina Vitreous       Date:  2021-01-06

Review 10.  Toxic anterior segment syndrome-an updated review.

Authors:  Choul Yong Park; Jimmy K Lee; Roy S Chuck
Journal:  BMC Ophthalmol       Date:  2018-10-25       Impact factor: 2.209

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