In additions, not all surgeries are created equal with respect to infection risk. Joint surgeries are some of the highest risk for infection. In fact, when doing open joint surgery, orthopedic surgeons will wear what looks like a space suit with helmet and air supply and work under a giant air suction device to keep the would from being contaminated. Add to that, that they were putting in foreign materials in the form of screws, and you have a recipe for disaster if there is the tiniest bit of contamination. As I have told my patients and medical students, a surgical infection is a life altering event. There is a good chance that you will never be the same after experiencing it.
I think this type of thing will be a bigger issue as we move forward. Surgical equipment is getting more intricate and more expensive. Everybody is pushing to cut costs. Having less equipment for a hospital is less capital costs, but more times that it needs to be properly cleaned, and every time you clean is an opportunity to screw up.
I think the ultimate answer might be taking the responsibility of sterilizing complex surgical equipment from the hospital to the manufacturer. Basically, the hospital would use the equipment once and send it back for reprocessing back to the manufacturer. For a lot of these surgeries, the manufacturer representatives are there at the hospital for surgeries requiring single use stuff likes screws, rods, artificial joints, etc so this would just add to the stuff they are bringing to the hospital anyway. It would be much easier for the FDA is o monitor and regulate a few reprocessing centers instead of every hospital. Simple equipment that you can just throw in an autoclave, can still be done by the hospital. Doing this would also force the manufacturers to think more about ease of cleaning since they would be the ones responsible directly for it.
Just my 2 cents.
In our hospital anything that came from a Rep, sterilized or not, HAD to be reprocessed as of it were used because there is no way to verify conditions between transport; humidity, height from floor/ceiling, biological incubation and results. On top of that sometimes Reps would only have a single tray but the doc would schedule 4 back to back caeses needing that set. Who gets the blame when it's not ready in time? Not anesthesia for putting the pt under too soon, not the doc for their inability to contact spd prior to scheduling cases, not the nurse for failure to check with the scrub, no it's the SPD staff.
Things like yankhauer and Poole suctions are impossible to clean; many packs come with disposable ones now. Hell, the vast majority of surgical equipment is disposable but hospitals are in the making money business and reuse is much cheaper. Many clinics in our hospital were unaware of how to reprocess their items and would turn in soiled items that sat all weekend covered in blood without any enzymatic cleaner; not to mention half their items were single use but are being treated as multi-use.
Man, I'm glad I moved to being an assist and even happier I left the surgical field in general.
What is it that makes such an infection is so impactful? Is there physical damage that persists, psychological trauma due to the experience, or some other factor?
Edit: Read the comments prior to reading the article.
> When Harrison awoke from that surgery, he imagined his nightmare was over. But in reality, it had just begun. Since then, what began as a simple operation has turned into a lengthy struggle that left him for months at a time dependent on hired nurses, unable to dress himself, take a shower, or work, and afraid for his life.
A few years ago there was an issue with this in Germany
Of course, my fear is that the contamination comes more from everything that's not the patient or the surgeon as it pertains to the surgery -- nurses, cleaning staff, etc. Every actor and entity in that chain needs to ensure sterility, so the screws would have to be sealed until opened, the cleaning staff would have to use these kinds of space suits (or clean remotely) and likewise for the nurses. Unless or until this all becomes possible, the whole system is not going to be set up for sterility.
I can imagine how an open joint surgery has a high infection risk for the patient. But how does it also impose a risk for the surgeon?
Can you expand on why that is? Do we know why joint surgeries are so problematic?