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Unused U.S. Surgical Supplies Could Improve Care for Third World Patients

BALTIMORE – Major hospitals across the United States collectively throw away at least $15 million a year in unused surgical supplies, according to new research that suggests the material could be salvaged and used to improve surgical care in developing nations.

A report on the research was published recently in the World Journal of Surgery. In it, Johns Hopkins researchers point out that salvaging the waste would be an opportunity for U.S. hospitals to help relieve the global burden of surgically treatable diseases, while also reducing the cost and environmental impact of medical waste disposal at home.

The investigation likely is one of the first systematic attempts to measure the national extent of the problem, the potential cost savings and the impact on patients' lives, according to study’s authors. They call for making donations of leftover operating room materials a standard protocol instead of the current situation where only some surgical facilities rely on organizations with donation programs.

"Perfectly good, entirely sterile and, above all, much-needed surgical supplies are routinely discarded in American operating rooms," pointed out lead investigator Richard Redett, MD, a pediatric plastic and reconstructive surgeon at the Johns Hopkins Children's Center. "We hope the results of our study will be a wakeup call for hospitals and surgeons across the country to rectify this wasteful practice by developing systems that collect and ship unused materials to places that desperately need them.”

Wasted surgical supplies often are the result of bundling surgical materials to streamline operating room readiness and efficiency. The problem, according to the researchers, is that once it’s opened everything in the bundle that is unused is thrown away.

"Such programs are acutely needed not only to help address serious needs in resource-poor settings but also to minimize the significant environmental burden at home institutions," added co-author Eric Wan, MD, a recent graduate of the Johns Hopkins University School of Medicine currently doing postdoctoral training at the National Institutes of Health. "This really is a win-win situation."

The study’s estimates were based on an existing program that recovers and delivers unused surgical supplies from The Johns Hopkins Hospital to two surgical centers in Ecuador. Items donated over a 3-year period from September 2010 to November 2013 were analyzed by quantity and weight, and an estimated projected value of the program was made assuming wider participation.

The authors tracked 19 high-demand surgical items donated to the Ecuadorian hospitals over three years, then extrapolated the amount and value of the donations to 232 U.S. surgical centers with caseloads similar to The Johns Hopkins Hospital.

Results indicate that, if the 232 American hospitals saved and donated unused surgical supplies, 2 million pounds of materials would be generated in a year, at a value of at least $15 million.

When the researchers then tracked outcomes among 33 Ecuadorian patients whose surgeries were made possible as a result of the donations, they found that donated surgical supplies prevented, on average, eight years of disability per patient.

In the study, materials topping the 19-item surgical supplies list included gauze, disposable syringes, sutures and surgical towels.

"Saving and shipping these materials is truly a low-hanging fruit enterprise, a simple strategy that could have a dramatic impact on surgical outcomes and public health in resource-poor settings and truly change people's lives," said Redett, who has been running the Johns Hopkins donation program since 2003.

Study authors caution, however, that items shipped should be tailored to the specific needs of each hospital. That prevents unnecessary shipping costs and avoids creating medical waste locally. The receiving hospital also must have a demonstrated capability and the equipment to clean and sterilize the shipped materials before use in the operating room, they add.