Why IFUs are important to reduce SSI

Stuart White and Emile Jubeli highlight the importance of Instructions for Use (IFUs) to ensure the effective decontamination of instruments, including those used in robot-assisted surgery.

In the UK, Public Health England (PHE) conducted a national survey in 2017 involving 95 NHS Trusts and 13 surgical specialties. In total, 1,807 SSI cases were documented with reoperations reported in 36.2% of all identified cases, and an associated delayed discharge rate of 34.1%.1 Additionally, 383 medical negligence claims related to SSI have been identified in data collected by the NHS Resolution between April 2012 and March 2017, which are estimated to cost £35.2 million.2

In 2012, a sudden increase in surgical site infection rates was reported among patients undergoing 'clean' surgery in England. Consequently, an investigation was triggered, where the increased incidence was attributed to improper reprocessing practices. The investigation highlighted inadequate maintenance of autoclave components and poor practices by staff, compounded by lapses in inspection of surgical sets. The investigation outcome was a series of recommendations from operator training, supervision, and staffing at the sterilisation units, in conjunction with formal inspection and reporting of by theatre staff.3

More publications have reported incidents where contaminated surgical instruments have been identified as the cause for transmission of SSI-causing pathogens.4-6 For example, data collected from 40 hospitals in Canada between 2011 and 2020 reported 4,751 infections related to surgical instruments and surgical procedures.7 Another Canadian study revealed that infections related to instruments and surgical procedures represented more than 35% of all healthcare-associated infections (HCAIs) recorded.8

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