title: A multicentre audit of single-use surgical instruments (SUSI) for tonsillectomy and adenoidectomy.
abstract: BACKGROUND
  Prions are resistant to conventional sterilisation procedures and, therefore, could be transmitted iatrogenically through re-usable adenoid and tonsil surgical instruments. Using disposable instruments would avoid the risk of transmission. We present the results of a complete audit loop using BBraun single-use surgical instruments (SUSI).
  
  
  METHODS
  This was a prospective multicentre audit. Surgeons were asked to fill in a standardised questionnaire recording details including postoperative complications, and evaluation of each piece of equipment compared with their own experience of conventional re-usable instruments. In the first cycle, constructive criticisms of the instruments were noted and the manufacturers modified the instruments accordingly. A second cycle of audit was subsequently undertaken.
  
  
  RESULTS
  A total of 86 patients were audited in the first cycle and 97 in the second cycle. Postoperative haemorrhage rate for both cycles was well within acceptable range. In the first audit cycle, surgeons generally found the Draffin rods, Boyle-Davis gag and bipolar diathermy forceps of poor quality and difficult to use. These were redesigned and, on repeat evaluation during the second audit cycle, were found to be just as good, if not better, than the re-usable instruments.
  
  
  CONCLUSIONS
  This study suggests that SUSI may be just as good as re-usable instruments. Furthermore, they may be more cost effective.
authors.affiliation: UCLH Head & Neck Centre, London, UK. pauloflynnlondon@aol.com
authors.forename: P
authors.initials: P
authors.lastname: O'Flynn
authors.forename: S
authors.initials: S
authors.lastname: Silva
authors.forename: P
authors.initials: P
authors.lastname: Kothari
authors.forename: R
authors.initials: R
authors.lastname: Persaud
mesh_terms: D000233:Adenoidectomy / Q000295:instrumentation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D011446:Prospective Studies; D014068:Tonsillectomy / Q000295:instrumentation*