Below is a message I recently received from an equipment supplier with my needle drivers, which I had sent in for repair.

Repair status: Life worn. Nonrepairable. DO NOT USE. Please be informed that instruments marked nonrepairable because of specific damage are not fit for surgical use. If a customer chooses to use these instruments, they are doing so at the risk of the patient.

The message reminds me some of the reasons why my practice, Pet Crossing in Bloomington, Minnesota, is so persnickety about the care of our surgical instruments and other equipment.

It all started with the purchase of the practice. As is typical, part of the purchase price covered the surgical instruments and equipment. The instrument medley included some burrs of unidentifiable vintage, heavy with rust and desiccated tissues. These fit on a low-speed drill that clearly had not been appreciated.

Part of the purchase agreement was working at the hospital for one month prior to the sale. During an alveoloplasty, I jammed a dull burr through my thumb, tearing muscle and tendon into the bone and joint capsule.

The patient had to have a double oral nasal fistula repair as part of the procedure. I carried on as all "just graduated and don't want to share the cool surgeries with anyone else" vets do.

I cleaned up the area on my thumb, leaving chlorhexidine on to mop up any residual guck, and bandaged up. After completing the surgery, I went to the emergency room and then a hand surgeon.

It was a painful lesson on the importance of the condition and quality of surgical instruments. Had I been using a sharp burr, the drill would have never been pushed into my thumb.

The scars on my thumb serve as a constant reminder of the importance of instrument and equipment maintenance.

Needless to say, soon after the purchase was completed, Pet Crossing had a protocol addressing instruments and equipment. Here it is in a nutshell:

After a patient is off the table and stable, instruments are freed of blood, placed in the ultrasonicator, and then air-dried.

Next, they are inspected for rust and wear. Those that are dull of have loose hinges or other issues are sent for maintenance. Those that need to be retired are plopped in the "morgue" of surgical instruments, waiting for the day when they can be repurposed in an art project or other inspired use.

At our hospital, the maintenance and care of equipment comes under our hospital, patient, client, and staff bill of rights. We recognize that our instruments are critical tools from which we generate income and care for our patients. They need to be well-maintained for us to perform procedures efficiently and safely.

Well-maintained instruments last a long time. Take care of your surgical instruments. Your thumb will thank you!

Check our Dr. Knutson's monthly View from the President column in October's Trends magazine, now available online.

This article originally appeared in the September 2013 issue of Trends magazine.



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