Reusable Textiles Within Surgical Sets Essay Example

Currently there is a debate on the usage of reusable textiles within surgical sets. There are many factors to consider when deciding on single-use or multi-use linen. One of the largest considerations is the lint created from the linen and its effect on the patient. Other aspects to examine include cost, quality, environmental impacts, and labor. 

Short fibers can separate from their parent textiles relatively easily creating lint. This lint can have many different points of origin including scrubs, drapes, tray liners, towels, etc. When the lint is lifted off it “may fall to the floor or other surface long enough for ever-present bacteria to latch on.”(Truscott, 1.) Staff walking through-out the suit, OR furniture being moved, or even air flow can cause the “contaminated lint [to become] a transport of bacteria.”(Truscott, 1.) In an AORN Journal entry culture swabs of items within the OR was conducted and found that “several potential nosocomial pathogens (e.g., Staphylococcus aureus, Staphylococcus epidermidis) and other drug-resistant isolates frequently were recovered from an area adjacent to the surgical field.”(Edmiston Jr.) Within the operating room this can have detrimental effects on patients as it increases their risk of contracting surgical site infections (SSI) just as any foreign debris would.  Attributed to Susan Ball in “Improving Outcomes in the Operating Room,” it is stated that “Foreign debris interferes with optimal wound healing and contributes to surgical site infections.”(10.) Many studies have been conducted to better understand just how much lint has contributed to negative impacts in the operating room and patient, as well as, ongoing Center for Disease Control and Protection (CDC) data collection. It is important to understand how much havoc SSIs alone can cause to better comprehend the impacts. In a 2015 study the CDC data revealed that “110,800… SSIs [are] associated with inpatient surgeries…” That number has increased to 157,500 in later years. SSIs are accredited with the most common healthcare-associated infections (HAI). In fact “it is reported, SSI accounts for 20% of all HAIs.”(CDC, 2.) Not only are patients staying on average 9.7 extra days, but their risk of mortality is increased “…with 75% of SSI-associated deaths directly attributable to the SSI.”(CDC, 2.)  Along with directly impacting patient health, SSIs are extremely expensive for all parties involved, including hospitals.  HAIs are estimated to cost the American healthcare system $9.8 billion, with 33% or $3.3 billion attributed to SSIs. It goes without saying that the reduction of SSIs is worth the trouble.

Lint with-in the operating room is not only attributing to infections, but also creates other complications such as adhesions, granulomas, and blood clots. In a study from 2021 article “Lint Fiber- Associated Medical Complications Following Invasive Procedures” a light is shown on 211 patients who suffer from long-term post-operative pain. The study shows that in “…91% of the patients, chronic adhesions were identified as the major cause of pain.” (Truscott,1.) In the 91% or 193 patients, 69% of the painful adhesions had a histopathologic evaluation done and found that they were formed from foreign bodies inside the surgical site. 66% of which were “the foreign bodies… of cellulose textile origin (cotton or paper-based fibers)” (Truscott, 1). The staggering numbers support the

To combat the increasing dangers of lint many hospitals have moved from the once universal usage of reusable textiles to single-use. In most surgical pacts single-use 100% cotton towels are provided. Many recognize these as the blue OR towel. Because they are single-use each towel is usable at the time they are needed unlike multi-use towels that “56% of… showed serious faults impairing functionality…” (Improving Outcomes in the Operating Room, 1) when a study was conducted comparing the two. The blue OR towels have a higher quality and better absorption creating a higher level of protection for OR staff. Although a majority of operating rooms have moved to single-use the growing concern for environmental impacts have caused some to revert back to reusable textiles. It is important for these facilities to check the OR towels instructions for use (IFU) determined by the manufacturer. Within the IFU instructions for the temperature, sterilizing time, and dry time will be annotated along with the amount of times the towels can be sterilized. According to the Association of periOperative Registered Nurses (AORN) and Association for the Advancement of Medical Instrumentation (AAMI) guidelines a tracking system of how many cycles the towels have been through must be implemented and the linen is to be thrown out after the number of cycle limitation have been met. When assembling sets containing linen it “requires more labor because it must be laundered and inspected to ensure there are no tears, punctures, worn sports, or stains from previous use.” (International Association of Healthcare, 2016.) It is also required that a lighted table is used to lay the linen over the light to properly check for faults. If any of these faults are discovered the linen must be removed from circulation in the use of sterile sets. Because reusable textiles meant for the use of surgery are often significant in lint a de-linting process must be established.  The de-linting process is recommended to occur outside of the sterile processing department (SPD) and by the laundry site as not to throw lint into the air and land in other nearby sets.

After comparing the two it is noticeable that neither are more cost effective than the other. The blue towel is a single-use item that does not yet have recycling guidelines, but does require laundry bills for the hospital or extra labor for SPD staff. The reusable towels last for about 50-75 cycles depending, but must also be thrown out and constantly restocked and require a large amount of labor to ensure the proper sterility of the towel and safety of the patient. If the hospitals SPD is not equipped with a light table and will need to purchase one may also be a determining factor between the two options. One can argue that the safety of patients and reduction attempts of SSIs is a far greater outcome.