The price of doing pediatric sinus procedures (a look at cost).
OBJECTIVE
Display the cost savings of minimal sterile covers and preparatory time while still maintaining optimal outcomes for sinus procedures. In-office non-sterile endoscopic sinus procedures have not shown a difference in infections and complications. Institutions continue to employ more "traditional" sterile preparation with similar procedures in the operating room. Multiple studies have also shown no significant difference in postoperative course when preoperative antibiotics are administered for sinus procedures.


METHODS
Endoscopic sinus procedures were selected (58 patients) to analyze itemized sterile costs. Drapes, gloves, gowns, and antibiotics were then tallied and compared to the same items for cochlear implants (14 procedures). The "sterile-prep" time was also analyzed and compared between the two procedures. Cost difference was analyzed.


RESULTS
Comparing the supplies used for sinus procedures (56) and cochlear implants, our average sinus cost was $10.19, compared to $34.64, with a difference of $24.45. This equated to a savings of $1418.00 in sinus procedure supplies that year. The difference in draping and scrubbing time showed a difference of 20 min between groups, equaling a value of $1760 difference/case. This calculated to a savings of $10,2080 for sinus operating room time. There was no difference in patient outcomes with this surgical preparatory approach.


CONCLUSIONS
Our analysis showed a large cost savings over a fiscal year in operative time and supplies. This did not compromise any patient outcomes given the already non-sterile nature of endoscopic sinus surgery. This practice can be adopted to greatly enhance efficiency without sacrificing surgical results.
Department of Pediatric Otolaryngology, Georgia Regents University, Augusta, GA, United States. Electronic address: bho@gru.edu.
Brian
B
Ho
Robert
R
Liebman
C Anthony
CA
Hughes
D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000191:economics* / Q000379:methods; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004724:Endoscopy / Q000191:economics* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009873:Operating Rooms / Q000191:economics*; D061646:Operative Time; D010256:Paranasal Sinuses / Q000601:surgery*; D010372:Pediatrics / Q000191:economics; D012189:Retrospective Studies; D013242:Sterilization / Q000191:economics; D014481:United States
Cochlear implant; Cost analysis; Functional endoscopic sinus surgery; Preoperative antibiotics