A Developing Country Reuse of Disposable Surgical Equipments & Infectious Rates

Said D Elias, MD1, Henry Lin, MD2. 1Peltier General Hospital, 2Naval Hospital Camp LeJeune

Intro: Surgery in developing countries can be hindered by the limited monetary funds, especially in the era with significant utilization of disposable surgical instruments.

Objectives: To review the infectious complications of the practice of utilization of decontamination instead of full sterilization in a hospital located in a developing country.

Methods: Unable to afford developed country sterilization standards, Peltier General Hospital in Djibouti resorted to decontamination of instruments, including typically disposable electrocautery devices. Case series of 7 years from 2007-2014 were collected & analyzed for infectious complication rates.

Results: Through large variety of cases, including gastrointestinal surgery, urology, thoracic, vascular, gynecology, thyroid, skin, & other soft tissue surgery, there was approximately a 7% infectious complication rate associated with decontamination method (but not full sterilization technique) & no standardized pre-operative antibiotics, higher than historical rates of 1.5% for clean surgical cases & 7.7% for clean contaminated cases.

Conclusion: Although developing countries may sometimes use decontamination rather than sterilization techniques, this practice increases overall infectious complications post-operatively.

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