Surgical Products, July/August 2015

May 2015

The No. 1 requested brand for surgeons, OR managers, and purchasers for more than 30 years.

Designing a Desirable Space: 10 Steps to Building a Successful Hybrid OR pg. 12

Solutions for Surgical Plume pg. 14 ESP Award Nominees pg. 33 New Options Bring Clarity pg. 48 SurgicalProductsMag.com

Enhanced Humbles LapWrap® Positioning Pad

Now even more secure with two-way performance!

Anesthesiologist Frank Humbles, M.D. knows the importance of patient positioning.

The Enhanced Humbles LapWrap®.

• Positions patients arms while allowing easy access for leads and IV’s • Secures patient to OR table • Is dual sided for increased flexibility • Optional extensions can be attached for the extremely obese

Designed to meet The operative word in patient positioning.

AORN recommendations

www.impmedical.com

Designed by an Anesthesiologist who understands patient and surgeon needs

Now you can secure your patient in place.

Loop the LapWrap® tab around the side rail of the OR table.

Bariatric Patients are no problem. The LapWrap’s® tab configuration also makes positioning bariatric patients easier.

Keep arms securely positioned. Designed to prevent tissue injury. Arms stay where you put them during the procedure.

Adaptable to all size patients. Use the optional extensions to secure the extremely obese.

The LapWrap® was designed to meet AORN recommendations in “Recommended practices for positioning the patient in the perioperative practice setting” to prevent tissue injury and ischemia that may be caused by tucking a patient’s arms at his or her side.

For more info or to order call 1-800-467-4944

US Patent No. 8,001,635

© 2015 IMP AORN is a registered trademark of AORN, Inc. AORN does not endorse any commercial company’s products or services.

AT LEAST

99.5% REDUCTION IN S. AUREUS

12

1

TREATMENT

HOURS

The evidence

is mounting.

Clinical evidence has demonstrated 3M™ Skin and Nasal Antiseptic is effective in reducing the risk of SSIs1. Make 3M™ Skin and Nasal Antiseptic (Povidone-Iodine Solution 5% w/w [0.5% available iodine] USP) Patient Preoperative Skin Preparation part of your pre-op protocol and take control over infection prevention, helping to improve procedural outcomes and lower MRSA readmission cost2. Within one hour of application, 99.5% of Staphylococcus aureus in the nares are reduced and patients are protected for at least 12 hours3.

Try it for yourself. Visit 3M.com/MoreControl for a free trial.

1. Phillips M., Rosenberg A., Shopin B., et al. Preventing Surgical Site Infections: a Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution. Infect Control Hosp EpidemiolI 2014;35(7):826-32 2. Waibel, M. (2013, June) Revisiting Process Improvement for Total Joint Arthroplasty Surgical Site Infections. Poster presented at the APIC National Conference, Ft. Lauderdale, FL. 3. 3M Study-05-011100.

© 2015 3M. All Rights Reserved.

EDITOR’S CHOICE

Derm 101 and Derm 102 Bovie Medical Corporation’s Derm 101 and Derm 102 are economical, 10 watt high frequency desiccators, thoughtfully designed to give practitioners the ability to perform in-office, minor skin procedures such as the removal of skin tags, benign lesions and premalignant lesions. www.boviemedical.com

Negative Pressure Wound Therapy (NPWT) PRO The Cardinal Health™ Negative Pressure Wound Therapy (NPWT) PRO family of products delivers therapy tailored for different care settings from the hospital to the home. The PRO line has a user interface that follows human-centric principles, offers continuous and intermittent mode therapy settings, and has up to 24 hours of battery life. www.cardinal.com

SYNTHECEL® Dura Repair DePuy Synthes CMF’s SYNTHECEL® Dura Repair is the first commercially available biosynthesized dural replacement derived from cellulose for use in neurosurgery.

The dura is a tissue membrane that covers and protects the brain and spinal cord. During neurosurgery, the dura may be cut to allow surgeons to access the brain. A dural graft, which is either bovine collagen or synthetic, is often required after interdural surgery to provide a watertight seal, protect cerebral tissue and reduce the risk of infection. www.depuysynthes.com

RDS-30 Spectra254’s RDS-30 Series uses six, custom-built UVC germicidal bulbs to eradicate pathogens. Its Ultra Pure Quartz Shelf allows UVC wavelength to reach the underside of an object. A visual, audio and a digital display provide information about each decontamination cycle. www.spectra254.com

4 July/August | 2015 | www.SurgicalProductsMag.com

Distributed by:

Fluid Management You Will Want To Use… Innovative Irrigation: Thermedx® FluidSmart™ System

• Simple to setup and use • Designed to withstand accidental bumps and movements • Real-time fluid deficit monitoring • On-demand procedure summary printouts

Simple, Safe & Effective System For Gynecology, Urology & Orthopedics

Try It Today At No Cost. www.allenmedical.com/sp9 or (800) 433-5774 | (978) 266-4200

FluidSmart™ and Thermedx® are trademarks or registered trademarks of Thermedx, LLC. © 2015 Allen Medical Systems Inc. All Rights Reserved. D-770766-A2

TABLE OF CONTENTS

Volume 34, Number 6

General Manager Tom Lynch, 973-920-7782 tom.lynch@advantagemedia.com

FEATURES 11 Determining Factors: Cost, Efficiency

Editorial Director Jeff Reinke jeff.reinke@advantagemedia.com

Changes in fluid disposal methods reflect demands and change in the industry

12 10 Steps to Building a Successful Hybrid OR

12

Experts give some advice to those considering an integrated system

Editorial Office Address: 199 E. Badger Road, Suite 101 Madison, WI 53713

14 Solutions for Surgical Plume While not everyone agrees it’s an issue, suppliers shared options for facilities that want more information

22 Consistency Improves Outcomes Prepared staff and involved patients mean better care

26 Changes Could Create Better Outcomes

14

ASA offers methods for anesthesiologists to gain a competitive edge

33 Excellence in Surgical Products Award Nominees

Some physicians lack education, which means not all candidates are reached

22

New options bring more clarity

Editor’s choice

7

What’s Trending

8

Reader’s Choice

Senior Account Manager Michael Costantino 402-863-6266; michael.costantino@infogroup.com

PRODUCTS 20 Surgical Plume Evacuation and Capture Devices 24 Patient Warming and Cooling/ Hypothermia

Prevention

Customer Service For subscription related matters contact Omeda Customer Service 847-559-7560 or absp@omeda.com List Rentals: Infogroup Targeting Solutions Senior Account Manager, Bart Piccirillo, 402-836-6283; bart.piccirillo@infogroup.com

DEPARTMENTS 4

Editorial Advisory Board Bruce Campbell, MD, FACS Leonardo Claros, MD, FASMBS William S. Cobb IV, MD, FACS Paul G. Curcillo II, MD, FACS Mary Hibdon, RN Homero Rivas, MD, MBA, FACS Christopher C. Rupp, MD Advertising Representative Kelly McCullick kelly.mccullick@advantagemedia.com 973-920-7797

45 Awareness Lacking for Treatment

48 4K Imaging

Editor Rebecca Rudolph rebecca.rudolph@advantagemedia.com

50

For custom reprints and electronic usage, contact YGS Group; 717-505-9701 x 2332; ABMreprints@theygsgroup.com

28 Infection Control Resource Guide 46 Carts and Storage 50 OR Visualization Monitors

Cover image courtesy of Maquet SURGICAL PRODUCTS® (ISSN #1062-4372, USPS #024-747), (GST Reg. #844559765) is a registered trademark of and and published 8 times per year (January, March, April, May, June, July, September, November) by Advantage Business Media, 100 Enterprise Drive, Suite 600, Box 912, Rockaway, NJ 07866-0912. All rights reserved under the U.S.A., International and Pan-American Copyright Conventions. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, electronic recording or otherwise, without the prior written permission of the publisher. Opinions expressed in articles are those of the authors and do not necessarily reflect those of Advantage Business Media or the Editorial Board.

Periodicals Mail postage paid at Rockaway, NJ 07866 and at additional mailing offices. POSTMASTER: Send return address changes to SURGICAL PRODUCTS, P.O. Box 3574.

Northbrook, IL 60065-3574. Publication Mail Agreement No. 41336030. Return undeliverable Canadian addresses to: Imex/Pitney Bowes, P.O. Box 1632, Windsor Ontario N9A 7C9.

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Notice to Subscribers: We permit reputable companies to send announcements of their products or services to our subscribers. Requests for this privilege are examined with great care to be sure they will be of interest to our readers. If you prefer not to receive such mailings, and want your name in our files only for receiving the magazine, please write us, enclosing your current address mailing label. Please address your request to Omeda Customer Service, P.O. Box 3574, Northbrook, IL 60065-3574.

Printed in USA: Advantage Business Media does not assume and hereby disclaims any liability to any person for any loss or damage caused by errors or omissions in the material contained herein, regardless of whether such errors result from negligence, accident or any other cause whatsoever. The editors make every reasonable effort to verify the information published, but Advantage Business Media assumes no responsibility for the validity of any manufacturers’ claims or statements in items reported. Copyright ©2014 Advantage Business Media. All rights reserved.

6 July/August | 2015 | www.SurgicalProductsMag.com

100 Enterprise Drive, Suite 600, Box 912, Rockaway, NJ 07866-0912 973-920-7000; Fax: 973-920-7542 Chief Executive Officer Jim Lonergan Chief Operating Officer/ Chief Financial Officer Theresa Freeburg

Chief Content Officer Beth Campbell

What’s Trending On The Web

?

What’s new on SurgicalProductsMag.com

With numerous outlets for news and information on new developments in the surgical community, it can be easy to slip into the habit of relying too heavily on one format or another.

Fortunately, as a reader of Surgical Products, you know about the print publication, daily e-newsletter and website (www.SurgicalProductsMag.com) as individual outlets for news, articles and product data.

mended practices for surgical attire. The recommendations are based on the latest clinical evidence of practices that help reduce the amount of microorganisms present in the perioperative environment in order to reduce risk associated with surgical site infections (SSIs). While the recommendations include the use of surgical masks and cover apparel, perhaps most interesting with respect to new science is the focus on scrub attire.

Trending on SurgicalProductsmag.com This is a quick look at what’s getting the most attention on Surgical Products’ website. Be sure to check out the website every day for new and exclusive content, or sign-up to receive our daily e-newsletter.

Exclusive to SurgicalProductsMag.com:

From Scratch Paper to the OR: New Robot Debuts in 2017

by Rebecca Rudolph, editor While Dennis Fowler, MD, MPH, was working at Columbia University, he and two of his engineering colleagues were talking and decided there had to be a better way to use technology to make MIS easier to learn and easier for patients to recover from. “We started with a clean sheet of paper and asked what’s the most efficient, least invasive, most ergonomic way for a surgeon to do an operation in the abdomen. This is what we came up with,” he said. This being the prototype for Titan Medical Inc.’s SPORT Surgical System.

Botox Can Reach Nervous System

by University of Queensland

Who Benefits From a Catheter – and Who Doesn't?

by University of Michigan Health System What's the only thing worse than having a urinary catheter when you're in the hospital? Having one and getting a urinary tract infection (UTI) - or worse - as a result. Now, a new detailed guide gives doctors and nurses information to help decide which hospital patients may benefit from a urinary catheter - and which ones don't. And that should help spare patients the pain, embarrassment, and potentially serious side effects that can come with having a catheter placed -- which may bring more risk than benefit to the patient.

®

Via-Guard EĞǁ ^ƚĂŶĚĂƌĚ ŝŶ ^ƵƌŐŝĐĂů ^ƵĐƟŽŶ

Vascular Andrews Stainless Steel

New research might bring a frown to even the most heavily botoxed faces, with scientists finding how some of the potent toxin used for cosmetic surgery escapes into the central nervous system. Researchers at The University of Queensland have shown how Botox - also known as Botulinum neurotoxin serotype A - is transported via our nerves back to the central nervous system. Botox - best known for its ability to smooth wrinkles - has been extremely useful for the treatment of over-active muscles and spasticity as it promotes local and long-term paralysis.

Exclusive to SurgicalProductsMag.com:

The Transformation of Healthcare Attire and its Role in Protecting Providers and Patients

by Amber Mitchell, DrPH, MPH, CPH and Bill Borwegen, MPH In November 2014 the Association of PeriOperative Registered Nurses (AORN) issued updated recomwww.SurgicalProductsMag.com | July/August | 2015 7

Prevent SSIs Ź ůŽŐ &ƌĞĞ ŝƐƉŽƐĂďůĞ dŝƉ Θ WŽŽůĞ ^ƵĐƟŽŶ Ź WƌĞǀĞŶƚƐ ƌŽƐƐ ŽŶƚĂŵŝŶĂƟŽŶ Ź ZĞĚƵĐĞƐ /ŶǀĞŶƚŽƌLJ ϱϬй GSA DAPA WOSB

www.SurgiMark.com | ဒϬϬ ϮϮဒ ϭϭဒϲ Request Samples | Watch Video | Locate Distributor

READERS’ CHOICE

Stryker’s PROFESS Navigation System As technology continues to evolve, more accurate naviation is not only becoming more accurate, it’s becoming more detailed. Stryker’s PROFESS Navigation System has been gaining attention from Surgical Products’ readers. It is designed to help surgeons maneuver the nasal cavity through a tracking algorithm and imaging system.

Q: What was the driving force behind the development of the PROFESS™ System?

A: The main driving forces for developing the PROFESS system include: • Increasing number of endoscopic sinus surgeries performed annually in hospitals, ASCs, and offices.

• ENT navigation is becoming a standard of care because it assists the surgeon in clarifying complex anatomy during sinus surgery.

• Typically, hospitals, ASCs, and office departments do not have large capital budgets in the ear, nose and throat (ENT) space.

• The goal with PROFESS is to provide customers with a cost effective navigation system which is both accurate and easy to use.

Q: This system offers a variety of features.

Q: What kinds of challenges did Stryker have in What steps can users take to ensure they are getting the most out of their investment? developing this surgical navigation software?

A: A few challenges included identifying suitable high- A: Customers should take advantage of the small and performance video tracking algorithms. Real-time video tracking and 3D reconstruction from video are major areas of research in the domain of computer vision and image processing. There are a large number of published, specialized algorithms and new algorithms are constantly being developed. The challenge was to identify a robust algorithm which worked not only under ideal laboratory conditions but also in the operating room (OR) or surgeon’s office. This includes a large range of different lighting conditions, effects like motion blur and partially occluded patterns. The product development team from Stryker teamed up with Europe’s largest teaching institution to short-list and evaluate potential candidate algorithms. The selected algorithms were then configured and extensively tested by Stryker to ensure that the accuracy is equivalent to that of active infra-red tracking systems like Stryker’s NAV3i® System.

8 July/August | 2015 | www.SurgicalProductsMag.com

portable Stryker ADAPT® Platform, which can be easily moved from OR to OR. They should also be aware that the PROFESS software has integrated an intuitive procedural workflow and even has video tutorials which guides the user how to set up the system and register the patient.

Q: What are some of the most unique benefits of this system and how will they benefit Surgical Products’ readers?

A: Many of our consultant surgeons and current customers highly value the level of accuracy the PROFESS System provides them throughout the procedure. Some other significant benefits of the PROFESS System include: • Lightweight and ergonomic instrumentation • Quick and easy patient registration • Precalibrated tools • Disposable driven to lower capital costs

In the management of postsurgical pain

A S M O O T H S TAR T TO RECOVERY BEGINS WITH EXPAREL Reduce the need for opioids while providing long-lasting pain control... all from a single dose • Indicated for single-dose administration into the surgical site to produce postsurgical analgesia

• DepoFoam1 ® uniquely delivers bupivacaine over time

• Eliminates the need for catheters2-5and pumps that may hinder recovery

• Demonstrated safety and tolerability profile similar to placebo

• Dose based on the administration site and the volume required to cover the area

Used in more than 1 million patients since 2012 6 The clinical benefit of the decrease in opioid consumption has not been demonstrated.

Important Safety Information EXPAREL is contraindicated in obstetrical paracervical block anesthesia. EXPAREL has not been studied for use in patients younger than 18 years of age. Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL. Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. In clinical trials, the most common adverse reactions (incidence ≥10%) following EXPAREL administration were nausea, constipation, and vomiting.

Please see brief summary of Prescribing Information on reverse side.

For more information, please visit www.EXPAREL.com or call 1-855-RX-EXPAREL (793-9727).

References: 1. How DepoFoam® works. Pacira Pharmaceuticals, Inc. website. http://www.exparel.com/how-to-use/about-depofoam.shtml. Accessed February 25, 2015. 2. Process for handling elastomeric pain relief balls (ON-Q PainBuster and others) requires safety improvements. Institute for Safe Medication Practices website. https://www.ismp.org/newsletters/acutecare/articles/20090716.asp. Accessed June 19, 2014. 3. I-Flow ON-Q pump with ONDEMAND bolus button. US Food and Drug Administration website. http://www.fda.gov/MedicalDevices/Safety/ListofRecalls/ucm317826.htm. Accessed January 5, 2015. 4. Continuous peripheral nerve blocks in outpatients. NYSORA–The New York School of Regional Anesthesia website. http://www.nysora.com/regional-anesthesia/foundations-of-ra/3055-continuousperipheral-nerve-blocks-in-outpatients.html. Accessed January 5, 2015. 5. Frost & Sullivan. New opportunities for hospitals to improve economic efficiency and patient outcomes: the case of EXPAREL™, a long-acting, non-opioid local analgesic. http://www.frost.com/prod/servlet/cpo/252218999. Accessed January 5, 2015. 6. Data on file. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; February 2015.

©2015 Pacira Pharmaceuticals, Inc., Parsippany, NJ 07054 PP-EX-US-0778 05/15

Brief Summary (For full prescribing information refer to package insert) INDICATIONS AND USAGE EXPAREL is a liposome injection of bupivacaine, an amide-type local anesthetic, indicated for administration into the surgical site to produce postsurgical analgesia.

EXPAREL has not been studied for use in patients younger than 18 years of age.

CONTRAINDICATIONS EXPAREL is contraindicated in obstetrical paracervical block anesthesia. While EXPAREL has not been tested with this technique, the use of bupivacaine HCl with this technique has resulted in fetal bradycardia and death.

WARNINGS AND PRECAUTIONS Warnings and Precautions Specific for EXPAREL As there is a potential risk of severe life-threatening adverse effects associated with the administration of bupivacaine, EXPAREL should be administered in a setting where trained personnel and equipment are available to promptly treat patients who show evidence of neurological or cardiac toxicity.

Caution should be taken to avoid accidental intravascular injection of EXPAREL. Convulsions and cardiac arrest have occurred following accidental intravascular injection of bupivacaine and other amidecontaining products.

Using EXPAREL followed by other bupivacaine formulations has not been studied in clinical trials. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL. EXPAREL has not been evaluated for the following uses and, therefore, is not recommended for these types of analgesia or routes of administration.

• epidural • intrathecal • regional nerve blocks • intravascular or intra-articular use EXPAREL has not been evaluated for use in the following patient population and, therefore, it is not recommended for administration to these groups.

• patients younger than 18 years old • pregnant patients • nursing patients The ability of EXPAREL to achieve effective anesthesia has not been studied. Therefore, EXPAREL is not indicated for pre-incisional or pre-procedural loco-regional anesthetic techniques that require deep and complete sensory block in the area of administration.

ADVERSE REACTIONS Adverse Reactions Reported in All Wound Infiltration Clinical Studies The safety of EXPAREL was evaluated in 10 randomized, double-blind, local administration into the surgical site clinical studies involving 823 patients undergoing various surgical procedures. Patients were administered a dose ranging from 66 to 532 mg of EXPAREL. In these studies, the most common adverse reactions (incidence greater than or equal to 10%) following EXPAREL administration were nausea, constipation, and vomiting.

The common adverse reactions (incidence greater than or equal to 2% to less than 10%) following EXPAREL administration were pyrexia, dizziness, edema peripheral, anemia, hypotension, pruritus, tachycardia, headache, insomnia, anemia postoperative, muscle spasms, hemorrhagic anemia, back pain, somnolence, and procedural pain.

DRUG INTERACTIONS EXPAREL can be administered undiluted or diluted up to 0.89 mg/mL (i.e., 1:14 dilution by volume) with normal (0.9%) sterile saline for injection or lactated Ringer’s solution. EXPAREL must not be diluted with water or other hypotonic agents as it will result in disruption of the liposomal particles.

EXPAREL should not be admixed with other local anesthetics.

EXPAREL may be locally administered after at least 20 minutes following local administration of lidocaine.

Bupivacaine HCl, when injected immediately before EXPAREL, may impact the pharmacokinetic and/or physicochemical properties of the drugs if the milligram dose of bupivacaine HCl solution exceeds 50% of the EXPAREL dose. The toxic effects of these drugs are additive and their administration should be used with caution including monitoring for neurologic and cardiovascular effects related to toxicity.

EXPAREL should not be admixed with other drugs prior to administration.

USE IN SPECIFIC POPULATIONS Pregnancy Category C Risk Summary There are no adequate and well-controlled studies of EXPAREL in pregnant women. Animal reproduction studies have been conducted to evaluate bupivacaine. In these studies, subcutaneous administration of bupivacaine to rats and rabbits during organogenesis was associated with embryo-fetal deaths in rabbits at a dose equivalent to the maximum recommended human dose (MRHD). Subcutaneous administration

of bupivacaine to rats from implantation through weaning, also at an MRHD-equivalent dose, produced decreased pup survival. EXPAREL should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Clinical Considerations Labor or Delivery Bupivacaine is contraindicated for obstetrical paracervical block anesthesia. While EXPAREL has not been studied with this technique, the use of bupivacaine for obstetrical paracervical block anesthesia has resulted in fetal bradycardia and death.

Bupivacaine can rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity. The incidence and degree of toxicity depend upon the procedure performed, the type, and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus, and neonate involve alterations of the central nervous system, peripheral vascular tone, and cardiac function.

Data Animal Data Bupivacaine hydrochloride was administered subcutaneously to rats at doses of 4.4, 13.3, and 40 mg/kg/day and to rabbits at doses of 1.3, 5.8, and 22.2 mg/kg/day during the period of organogenesis (implantation to closure of the hard palate). No embryo-fetal effects were observed in rats at the doses tested with the high dose causing increased maternal lethality. An increase in embryo-fetal deaths was observed in rabbits at the high dose in the absence of maternal toxicity. This dose is clinically relevant as is comparable to the MRHD based on Body Surface Area (BSA) comparisons.

In a rat pre- and post-natal development study conducted at subcutaneous doses of 4.4, 13.3, and 40 mg/kg/day with dosing from implantation through weaning (during pregnancy and lactation), decreased pup survival was observed at the high dose, a clinically relevant dose as it is comparable to the MRHD based on BSA comparisons.

Nursing Mothers Published literature reports that bupivacaine is present in human milk at low levels; however, the drug is poorly absorbed orally. Exercise caution when administering EXPAREL to a nursing woman.

Pediatric Use Safety and effectiveness in pediatric patients below the age of 18 have not been established.

Geriatric Use Of the total number of patients in the EXPAREL wound infiltration clinical studies (N=823), 171 patients were greater than or equal to 65 years of age and 47 patients were greater than or equal to 75 years of age. No overall differences in safety or effectiveness were observed between these patients and younger patients. Clinical experience with EXPAREL has not identified differences in efficacy or safety between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Hepatic Impairment Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, these drugs should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations.

Renal Impairment Bupivacaine is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Care should be taken in dose selection of EXPAREL. OVERDOSAGE In the clinical study program, maximum plasma concentration (Cmax) values of approximately 34,000 ng/mL were reported and likely reflected inadvertent intravascular administration of EXPAREL or systemic absorption of EXPAREL at the surgical site. The plasma bupivacaine measurements did not discern between free and liposomal-bound bupivacaine making the clinical relevance of the reported values uncertain; however, no discernable adverse events or clinical sequelae were observed in these patients.

DOSAGE AND ADMINISTRATION EXPAREL is intended for single-dose administration only. The recommended dose of EXPAREL is based on the surgical site and the volume required to cover the area.

Surgery

Dose of EXPAREL

Volume of EXPAREL

Bunionectomy1

106 mg

8 mL

Hemorrhoidectomy2

266 mg

20 mL

1

Infiltrate 7 mL of EXPAREL into the tissues surrounding the osteotomy and 1 mL into the subcutaneous tissue.

2

Dilute 20 mL of EXPAREL with 10 mL of saline, for a total of 30 mL, and divide the mixture into six 5 mL aliquots. Perform the anal block by visualizing the anal sphincter as a clock face and slowly infiltrating one aliquot to each of the even numbers.

Administration Precautions Admixing EXPAREL with other drugs prior to administration is not recommended.

• Non-bupivacaine based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more.

• Bupivacaine HCl, when injected immediately before EXPAREL, may impact the pharmacokinetic and/or physicochemical

properties of the drugs if the milligram dose of bupivacaine HCl solution exceeds 50% of the EXPAREL dose. The toxic effects of these drugs are additive and their administration should be used with caution including monitoring for neurologic and cardiovascular effects related to toxicity.

• When a topical antiseptic such as povidone iodine (e.g., Betadine®) is applied, the site should be allowed to dry before EXPAREL is administered into the surgical site. EXPAREL should not be allowed to come into contact with antiseptics such as povidone iodine in solution.

Studies conducted with EXPAREL demonstrated that the most common implantable materials (polypropylene, PTFE, silicone, stainless steel, and titanium) are not affected by the presence of EXPAREL any more than they are by saline. None of the materials studied had an adverse effect on EXPAREL. Non-Interchangeability with Other Formulations of Bupivacaine Different formulations of bupivacaine are not bioequivalent even if the milligram dosage is the same. Therefore, it is not possible to convert dosing from any other formulations of bupivacaine to EXPAREL and vice versa.

Dosing in Special Populations EXPAREL has not been studied in patients younger than 18 years of age, pregnant patients or patients who are nursing.

CLINICAL PHARMACOLOGY Pharmacokinetics Local infiltration of EXPAREL results in significant systemic plasma levels of bupivacaine which can persist for 96 hours. Systemic plasma levels of bupivacaine following administration of EXPAREL are not correlated with local efficacy.

CLINICAL STUDIES The efficacy of EXPAREL was compared to placebo in two multicenter, randomized, double-blinded clinical trials. One trial evaluated the treatments in patients undergoing bunionectomy; the other trial evaluated the treatments in patients undergoing hemorrhoidectomy.

EXPAREL has not been demonstrated to be safe and effective in other procedures.

Bunionectomy A multicenter, randomized, double-blind, placebo-controlled, parallelgroup study evaluated the safety and efficacy of 106 mg EXPAREL in 193 patients undergoing bunionectomy. The mean age was 43 years (range 18 to 72). Study medication was administered directly into the wound at the conclusion of the surgery, prior to wound closure. Pain intensity was rated by the patients on a 0 to 10 numeric rating scale (NRS) out to 72 hours. Postoperatively, patients were allowed rescue medication (5 mg oxycodone/325 mg acetaminophen orally every 4 to 6 hours as needed) or, if that was insufficient within the first 24 hours, ketorolac (15 to 30 mg IV). The primary outcome measure was the area under the curve (AUC) of the NRS pain intensity scores (cumulative pain scores) collected over the first 24 hour period. There was a significant treatment effect for EXPAREL compared to placebo.

In this clinical study, EXPAREL demonstrated a significant reduction in pain intensity compared to placebo for up to 24 hours. The difference in mean pain intensity between treatment groups occurred only during the first 24 hours following study drug administration. Between 24 and 72 hours after study drug administration, there was minimal to no difference between EXPAREL and placebo treatments on mean pain intensity.

Hemorrhoidectomy A multicenter, randomized, double-blind, placebo-controlled, parallelgroup study evaluated the safety and efficacy of 266 mg EXPAREL in 189 patients undergoing hemorrhoidectomy. The mean age was 48 years (range 18 to 86). Study medication was administered directly into the wound (greater than or equal to 3 cm) at the conclusion of the surgery. Pain intensity was rated by the patients on a 0 to 10 NRS at multiple time points up to 72 hours. Postoperatively, patients were allowed rescue medication (morphine sulfate 10 mg intramuscular every 4 hours as needed). The primary outcome measure was the AUC of the NRS pain intensity scores (cumulative pain scores) collected over the first 72 hour period. There was a significant treatment effect for EXPAREL compared to placebo.

In this clinical study, EXPAREL demonstrated a significant reduction in pain intensity compared to placebo for up to 24 hours. The difference in mean pain intensity between treatment groups occurred only during the first 24 hours following study drug administration. Between 24 and 72 hours after study drug administration, there was minimal to no difference between EXPAREL and placebo treatments on mean pain intensity; however, there was an attendant decrease in opioid consumption, the clinical benefit of which was not demonstrated.

Pacira Pharmaceuticals, Inc. San Diego, CA 92121 USA Patent Numbers: 6,132,766 5,891,467 5,766,627 8,182,835 Trademark of Pacira Pharmaceuticals, Inc.

For additional information call 1-855-RX-EXPAREL (1-855-793-9727) Rx only

May 2015

Fluid Management

Determining Factors: Cost, Efficiency Changes in fluid disposal methods reflect industry demands

by Rebecca Rudolph, editor

T

here are few jobs where exposure to commonly encountered fluids can result in extensive testing and legal follow up. Then again, surgical teams are unique in many ways, but that’s why it’s important each facility develops a seamless approach to fluid disposal to minimize risk.

These systems need to be efficient during and after the surgical procedure, and effective so the surgery isn’t delayed by malfunctioning equipment or hazardous spills during clean up, said Dr. Douglas J. E. Schuerer, FACS, trauma surgeon at Washington University School of Medicine.

While there’s nothing exciting about getting rid of bodily fluids and other waste, he says the system they have is effective and does what it needs to do. “The fluids are disposed of in a pretty straight forward way,” he observed.

It doesn’t matter how it’s done, as long as the fluid is removed and efficiently disposed of so staff can move onto the next case, he said.

Compared to 30 years ago, the approach to fluid disposal has changed a lot, reflected Candace Samudio, MBA, BSN, RN, CNOR, CLNC, manager of clinical excellence at Zimmer Surgical. The goal has always been to be efficient without spilling or creating a mess, she said, but concepts like blood borne diseases and environmental stewardship are new influencers.

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“A growing number of healthcare facilities are adopting fluid management systems as a best practice to reduce the amount of hazardous waste sent to incinerators and landfills in their communities,” she elaborated.

This might be discussed and implemented, but only if it makes sense with a more important factor in mind - cost, Terri Clouse, RN, CNOR, clinical consultant for Bemis, added; this includes the cost of equipment and staff time.

While OR turnaround times vary at each facility, she said when she was a nurse, her team would try to have the room ready for the next procedure in less than 10 minutes. Being prepared was one piece of this quick exchange, but being able to remove fluids right away was key, she explained. “That fluid has to be removed from the OR before you can begin set up for the next case, because that’s considered contaminated,” she elaborated.

As a facility chooses its fluid disposal methods, it’ll think about the surgeries its team perform, as well as its budget, Clouse explained. In the end, the system has to work well and help staff meet their turnover goals, she said. That’s why suppliers put so much time in to developing products that work the way they’re supposed to every time they’re used, she concluded.

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© 2015 Zimmer Surgical, Inc.

Hybrid OR

10 Steps to Building a Successful Hybrid OR Experts gives some advice to those considering an integrated system

by Rebecca Rudolph, editor

H

ybrid operating rooms (ORs), or integrated ORs, can be assets to a facility if they’re designed, built and organized correctly. Industry professionals who have led these multi-million dollar projects have broken the process down to 10 basic steps.

1. Make Sure It Fits With the Facility’s Mission “Where I’ve seen hybrid ORs not fully utilized with full satisfaction is when the administration, or a key surgeon, demanded a hybrid OR be built because the competitive facility down the street had one,” Darko Spoljaric, vice president of marketing at NDS Surgical Imaging, said. It’s important this decision is part of a long-term facility vision, he explained.

Trudy Kenyon, MSN, RN, CNOR, clinical nurse educator for systems integration at Olympus, agreed, adding it should also fill an unmet need. “You have to look at the current challenges with how the space is functioning today, as well as evaluate how you’d like the space to function in the future. That will help determine how the hybrid OR can meet the facility’s needs,” she said.

2. Specify the Surgeries It Will Be Used For “It’s important for the organization to determine what they want to use the room for (early in the project),” Diane Currier, senior clinical director of perioperative services at Scottsdale Osborn Medical Center, said, adding this will help determine what equipment is necessary, how big the room has to be and where in the building it should be located.

3. Find Your Stakeholders With the type of OR established, stakeholders are easier to identify. For Currier, the list includes OR managers, surgeons, facility directors, imaging leaders, anesthesiology leaders and other physicians. As the project moves along, more people will be added, but the core group needs to figure out what they want the final product to include.

4. Identify the Construction Plan Figuring out where to put a hybrid OR is a challenge in any facility, Currier said, but especially for older facilities with smaller rooms since hybrid ORs demand space to accommodate equipment. Facilities can either renovate or build.

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By remodeling, the idea is it would be a little cheaper.

Depending on the age and set up of the facility, that’s not always true, she clarified. For instance, older buildings don’t always have the right electrical set up, air flow systems and room layout.

If a facility decides to build an addition or new facility for the hybrid OR, the benefits are obvious – a new space, organized layout, efficient electrical set up, ideal ceiling height and more – but they can cost more and take longer to construct.

Either way, this decision needs to be made before the designing starts, she said. It will give facilities a better idea of the space they’ll have available, and what features the equipment will have to offer.

5. Selecting Suppliers The next step is to figure out who they want to create an ongoing relationship with for the lifetime of the hybrid OR. “Just because you decide to select one of the big name brand manufacturers, or someone with a large market share presence doesn’t necessarily mean you’re going to get the best results or the best attention for your facility and staff,” Spoljaric said. Instead, he suggests project leaders learn more about the suppliers. Below are a few things to talk about: • Working Partnerships: While the facilities choose who they purchase from, extra insight is always beneficial, he added. Normally, suppliers work together in areas like medical imaging radiology, systems integration, equipment arms and surgical lighting.

• Communication approaches: “While some do it better than others, there is no secret sauce to the perfect project,” Spoljaric said. “It really comes down to really great communication and execution amongst the whole team.”

• Staff education: Suppliers lead education. If surgical teams aren’t comfortable or confident using the technology, it could result in abandonment of the new hybrid OR, not to mention the possibility of less desirable patient outcomes, he said.

• Previous customer experience: During site visits, schedule a one-on-one with the project leader to hear what their experience was like, if they’d recommend the manufacturer, what communication was like, if there were cost overruns and, if so, what caused them, he suggested.

Hybrid OR

6. Designing for Function This process, which Spoljaric said normally takes a facility working with a manufacturer about three to six months, is complex, because it includes budgets, stakeholder opinions, many questions and the overall goal of designing for maximum function. “The last thing you want to do is design a room that has very low utilization,” Currier said. In addition to planning for what the room is used for initially, it’s also wise to plan for the future, they said. This can include things like extra conduits or mobile equipment.

will validate their system, and then the systems integration team will check for overall integration function.

9. Settling into a New Home Once the room is set up, Kenyon said it’s a process to settle in and learn its ins and outs. "We know when there’s pressure to perform, it’s harder for people to perform, so clinicians need time to practice when they don’t have the pressure of a patient on the table and a difficult or critical procedure to execute,” she said.

7. Regulatory Approval

10. Evolving and Growing

After the planning process is complete, the state and county need to approve the project construction master plan, Spoljaric said; this could take another three to six months.

Technology will only continue to evolve, so facilities and their manufacturers need to discuss new options as they arise, Spoljaric projected. Education also needs to continue so facilities get the most out of their investment, he said.

“Even if you spend more to get state-of-the-art, you can generally estimate with average training of both clinical staff and the surgeons, that you're going to utilize about 25 percent of the features and benefits of the system,” he said.

After everyone has had time to get acquainted with their new surroundings, a good educator can push them to new levels of mastery by regularly scheduling in-services that teach them new skills and emerging procedures.

8. Construction and Installation After about six-12 months of planning and waiting, the construction is completed, and manufacturers will start installing their equipment. The suppliers will have an install schedule agreed upon during the planning phase of the project. Often multiple vendors may need to be installing their products at similar times.

This takes coordination so that each vendor has access and the space to work safely and efficiently, Kenyon said. Each vendor

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Surgical Plume

Solutions for Surgical Plume While not everyone agrees it’s an issue, suppliers shared options for facilities that want more information.

by Rebecca Rudolph, editor

T

he whole story surrounding surgical plume is a little up in the air, only, in this case, there’s a pretty solid way to suck up all the fragments. Experts are starting to talk about it more – including the International Council on Surgical Plume (ISCP), suppliers and surgical team members.

Some people agree with the issue presented, and some say it’s all smoke and mirrors set up by the industry to get facilities to spend money on new equipment. Instead of arguing which side is right, let’s just take a moment and talk about the solutions so, if a facility sees surgical plume as a problem, options are identified.

Smoke capture and evacuation suppliers Here, a filter is being used during a laparoscopic procure. (Courtesy of CooperBuffalo Filter, Cooper-Surgical, I.C. Medical, Surgical) Megadyne, Nascent Surgical and Stryker offered their input on the issue. Since there the plume. Combined, AORN reports these elements make up haven’t been independent associations or organizations to about 5 percent of the smoke created during surgery. The other champion the cause, with the exception of the ICSP, which 95 percent of the plume is water, which acts as the carrier. was formed in April, suppliers have tried to educate the AORN reports chronic inhalation affects healthcare workers industry about the issue they’ve seen for the last couple of in a variety of ways, including: eye, nose and throat irritation; decades. In recent years, a handful of professional organizaheadaches; nausea and dizziness; runny nose; coughing; respitions have created policies on how surgical smoke should ratory irritants; fatigue; skin irritation and allergies. While the be approached, including the Association of periOperative electrosurgical smoke and its impacts are reportedly similar to Registered Nurses (AORN). those of laser surgery, regulations don’t surround electrosurgery procedures like they do laser surgery procedures.

Defining the Problem Some facilities and staff take precautions against electroTo better understand the solutions, surgical smoke, also known surgical plume by wearing surgical masks and respirators. as surgical plume, has to be defined. According to AORN, surNormally, surgical masks only filter out particles that are gical smoke is created during electrosurgical and laser surgery five microns in size and larger. The particles in electrosurgiprocedures when a patient’s tissue is cauterized with devices that cal smoke come in two relative sizes – large and small, the transfer heat to the surgical site. The plume that is released conJournal of Endourology reported. The larger particles are tains about 150 different identified chemicals, such as acrolein, bigger than 500 nanometers and the smaller ones are smaller benzene, carbon monoxide, formaldehyde, hydrogen cyanide, than 500 nanometers. Just for some perspective, 1,000 nanomethane, toluene and polycyclic aromatic hydrocarbons. Many of meters is the size of one micron. these are found in cigarettes, so the common argument from capSo, while these masks do offer some protection, surgical ture and evacuation advocates is: facilities wouldn’t allow smoksmoke capture and evacuation suppliers argue it isn’t enough. ing in the facility, so why would they allow plume to float around They also agree any exposure to it for any length of time isn’t the operating room? healthy for anyone, including patients. Factors like genetics, In addition to these chemicals, viruses, bacteria, carbonized tis- pre-existing illnesses and exposure levels can result in greater sue and more are released from the patient and carried around by For more, see page 16

14 July/August | 2015 | www.SurgicalProductsMag.com

Surgical Plume Smoke capture pens and pencils are one option impacts on some patients than others. to capture surgical smoke during open surgery There are no national or state laws in procedures. (Courtesy of Buffalo Filter) place in the United States concerning surgical smoke for electrosurgical equipment, so it’s really up to the facility if they want to address this concern. Various groups have tried pushing for legislation that they argue would protect healthcare workers and patients, but nothing has come of it.

“According to the ICSP, the United States is far behind Europe in terms of embracing and implementing smoke evacuation as standard operating procedure,” Dave Osborn, Stryker Instruments brand manager, said. “Ultimately, the Joint Commission may step in and stiffen their guidelines relative to smoke evacuation. It is our hope that facilities will get out in front of this change as opposed to operating in reaction mode.”

The Canadian Standards Association Smoke capturing devices can be incorporated into the electrosurgical tool, and some (CSA) published a specific set of standards can be an external attachment. (Courtesy of Megadyne) on smoke evacuation, which includes eleccoworkers’ health and they’re told no, normally they drop trosurgical smoke, in January 2009. In addithe issue. They’re starting to stand their ground though, he tion to the OR, Canada’s policy identified risks in dental clinics, noted, mentioning the other countries that have established morgues and research and testing facilities. This document was encouraging policies. used as reference for polices in other countries, including New If a facility does say yes, there are quite a few options on the South Wales, Australia, which released its policy in January market for them to choose from, but they really boil down to 2015. More countries have followed suit, including Denmark, four product categories – wall suction devices with in-line filGreat Britain and Norway. ters, portable smoke evacuation systems, central smoke evacua“The United States is recognized for being an extremely protion systems and laparoscopic evacuation devices. gressive and health conscious nation, so it is startling when you Because open surgical smoke disperses at a rate of about take a step back and realize that we are exposing our surgical teams and patients to toxins and carcinogens for hours at time in 40 miles an hour, meaning the room’s inhabitants are quickly exposed to the contaminants, suppliers agree a powerful a very confined area (the OR),” Jill Skoczen, Megadyne marketsuction device needs to be hooked up to the capture tool so ing manager, said. the tainted air doesn’t have a chance to escape and carry the Advocates for Change chemicals and other components of the plume away from the surgical site. Since there is some debate as to whether Without the incentive of government mandates, facilities make the decision themselves. “I believe the primary motivating factor wall suction is strong enough to remove the majority of the for facilities who make the move to evacuate smoke is staff safety, plume, suppliers recommend portable, high-powered suction devices be used with a disposable filter. and in most cases, movement in that direction begins with presWhile the suction tool is important, the methods of getting the sure from nurses on doctors and OR managers,” Osborn said. plume away from the surgical site is also a strong component to James White, I.C. Medical sales manager, agrees nurses are the program, expert say. In open surgery, different options, such the big advocates. “They are the ones that are in the operatas surgical smoke pencils, adapter pens, open tubing and larger ing room all day, every day. The nurses need to work with the surgeons and other O.R. staff to really drive the change in their capture devices are available. Smoke evacuation pencils are available both in fully integrated electrosurgical/smoke hand pieces hospitals,” he said. or attachable shrouds with tubing that connects to existing elecLeonard Schultz, M.D., Nascent Surgical founder and trosurgical pencils, and both collect plume as the surgeon works.

CEO, agreed, but added the only problem is when they try For more, see page 18 to stand up for their health, the patients’ health and their

16 July/August | 2015 | www.SurgicalProductsMag.com

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Surgical Plume The larger devices can be secured about one to two inches from the smoke source in the sterile field to collect the plume. No matter the tool, the goal is always the same – place the capture tool as close to the surgical site as possible to collect the most smoke.

“What we’re trying to say is, because we’ve come to realize the negative effects of chronic inhalation of nanoparticles on people’s health over time, you’re best using a product with maximum smoke capture efficiency,” Schultz said.

For laparoscopic surgery, there’s another set of options.

During the procedure, the patient’s abdomen is typically inflated with CO2, and the tools work inside the inflated cavity, meaning all the smoke would be contained. At the end of the procedure, the patient’s stomach is compressed to release CO2 and accumulated plume. When using a smoke evacuation device, the air is evacuated from the abdomen, running through intra-abdominal tubing, which is filtered to remove any harmful bacteria before being released into the OR environment.

There are two options for captures devices that hook onto trocars – ones that capture and evacuate the plume throughout the procedure, and ones that do it at the end of the procedure.

“For laparoscopic procedures, smoke evacuation helps keep the patient from absorbing all of the surgical plume,” White said. “In addition, smoke evacuated in laparoscopic procedures helps clear the view for the surgeon, making his or her job easier and save time per procedure.”

All of these capture tools are single-use because of the bacteria they collect and their direct contact with patient fluids.

“In today’s environment, when people are trying to contain costs, they always worry about adding something that has a new cost to a procedure. I think as more and more (surgical teams and hospital administrators) become aware of the dangers of surgical smoke, we would hopefully see an increase in utilization of devices,” Dr. Robert Auerbach,

Larger smoke capture devices can also be positioned just inches from the surgical site to capture plume. (Courtesy of Nascent Surgical) 18 July/August | 2015 | www.SurgicalProductsMag.com

FACOG, Cooper-Surgical’s executive vice president and chief medical officer, said.

Although they all prefer their own tools, most suppliers say it doesn’t matter what suction or filtration device facilities buy or what capture devices are chosen as long as a facility recognizes the problem and finds a solution that fits best with their team. “While there are variations in features and design, is one really better than another? The best smoke evacuation pencil is the one the surgeon is comfortable with and will use, thus protecting the OR staff from hazardous smoke exposure. When it comes down to it, something is better than nothing,” Skoczen said.

Another way to manage surgical plume is proper air flow in the OR, Auerbach said. “I don’t believe a facility will get away with a one product meets all. I do believe they will be able to have a triple approach,” he said. This includes having an option for open surgery and laparoscopic surgery, but also effective ventilation, or air turnover, in the room.

In open surgery, ideally, air would be forced down in an appropriate pressure over the sterile field, pushing the contaminates down and away from the surgical site as plume is captured, he explained. If that’s not done, wall suction can be used, but those displaced particles can still float or linger by the patient, increasing their risk, and the surgical team’s exposure.

Policy Once a facility adopts the new method and agrees to purchase the equipment, the next hurdle is getting it to be consistently used. The suppliers all agreed this requires policy.

“Education has played, and will continue to play, a key role in the acceptance. However, driving change is not easy,” Sherri Lloyd, Buffalo Filter product marketing manager, said. “The first step in any change process is deciding that you want to and will change your practice.”

This is done by identifying stakeholders who want to create change, adhere to regulations and provide recommendations, she explained. “Finding a surgeon to help champion the cause is especially helpful,” she added.

“Once a hospital mandates plume evacuation, surgeon acceptance is key.”

Education is a big part of it, because if staff members understand why they have to use it, they’re more willing to integrate it in their process, Osborn added. “We generally start the process with problem education and then transition into helping with the product implementation,” Osborn said. “During product trials, there tends to be a large amount of problem education along with coaching of staff on the subtle changes to room set-up and equipment usage.”

Other suppliers also say they find themselves being the go-to sources on surgical plume, but, with the ICSP, new, objective data is starting to be organized.

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Zip Pen Smoke Evacuation Pencil Zip Pen offers ergonomics and significantly less torque on the back end of the pencil. With a focus on comfort, the Zip Pen also offers surgeons three ergonomic grip options based upon their personal preferences, including trigger grip, over the band grip and traditional grip. www.icmedical.com

Plume-Away Laparoscopic Smoke Evacuation System The Plume-Away® multistage filter is a passive, disposable system able to clear particulates, smoke, and aerosolized pathogens while simultaneously absorbing odors and chemical toxins in laparoscopic procedures. The Plume-Away system functions without a vacuum pump, ensuring greater visibility to the surgical field. Simply connect the PlumeAway to the trocar side port, for a single, simple connection without the need for additional tubing. www.coopersurgical.com

RapidVac Smoke Evacuator System & Valleylab Smoke Evacuation Pencils Covidien’s RapidVac™ smoke evacuator system is designed to effectively capture and filter surgical smoke to remove odor, particulates, and other potentially hazardous byproducts of electrosurgery procedures. The Valleylab™ smoke evacuation pencils provide an ergonomic and versatile option. www.covidien.com

20 July/August | 2015 | www.SurgicalProductsMag.com

PRODUCT SPOTLIGHT: Surgical Plume Evacuation, Capture Devices

PlumePen Pro PlumePen® Pro is Buffalo Filter’s newest offering in surgical plume evacuation pencils. Featuring a 360-degree swivel, transparent capture port, and compact design, PlumePen Pro is a cost-effective solution combining precision surgical smoke management and electrosurgery without compromising quality and features. www.buffalofilter.com

Zip Pen Smoke Evacuation Pencil Zip Pen is significantly more ergonomic than current electrosurgical pencil designs, with significantly less torque on the back end of the pencil than standard smoke evacuation pencils as well as standard nonsmoke evacuation pencils. With a focus on comfort, the Zip Pen also offers surgeons three ergonomic grip options based upon their personal preferences, including trigger grip, over the band grip and traditional grip. www.megadyne.com

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Patient Handling

Consistency Improves Outcomes Prepared staff and involved patients mean better care

by Rebecca Rudolph, editor

L

eading up to their surgery, patients have worked with a handful of strange faces, and the day of surgery, they meet with at least a dozen more. “They are typically overwhelmed. There’s a lot to deal with and a lot to take in, especially if they’re elderly,” Lisa Spruce, DNP, RN, CNS-CP, CNOR, ACNS, ACNP, said. She’s the director of evidencebased perioperative practice at the Association of periOperative Registered Nurses (AORN).

While it’s stressful to be part of the surgical team and have the health of multiple patients in mind every day, the way a patient is moved around a facility and handled greatly impacts their experience, which is becoming more important as healthcare turns to a market place structure.

Patient handling devices increase safety for both healthcare staff and patients. (Courtesy of American Nurses Association)

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To make sure each patient receives quality care, Spruce said the responsibility to stay organized and communicate falls to both the patient and healthcare worker. Patients should arrive early with all testing completed and all the pre-surgical protocol met, she explained. Staff members should work ahead and plan for future patients so if there’s a missing test result or misfiled piece of information, it can be found and cataloged before the patient arrives, causing less delay, she added.

If both parties are organized, there should be less confusion, and thorough communication can clear up any other questions, she continued. Throughout the process, patients should be included in everything - where the surgical incisions will be made, what the procedure will include, how pain will be managed and more, she said. “Anytime there’s a concern or question raised by a patient in the pre-op area, we would want to make sure that gets resolved before we continue onto surgery,” she explained. “We don’t want anyone back there who doesn’t understand what’s happening to them.”

As patients move through the chain of people, from registration to the perioperative nurse to the anesthesiologists to the circulating nurse and so on, patients are normally pretty mobile, with a fraction of them in wheelchairs, she observed.

Patient Handling The mobility of patient information is a little trickier, especially if the different people along the route don’t communicate properly, Spruce said.

She recommends facilities develop a consistent communication method for staff to use to make sure everyone is on the same page with the patient and mistakes aren't made. This could be something simple as an acronym like SBAR, which stands for situation, background, assessment and recommendation. What’s important is it’s something that will work every time, she said. “(Facilities) have to develop it, chose something on their own, and then the whole facility needs to embrace it.”

Once the patient reaches the OR, it’s important to have a patient handling device ready and available for when they leave, she said. “I think there’s a huge gap in appropriate patient handling equipment. Almost every patient after their surgery, when they’re finished and going from operating room bed to stretcher, unless they’re wide awake, will need some assistance.”

Patient Positioning

By Isabelle Werkheiser, Director of Marketing at HoverMatt Performing lateral patient transfers and positioning in the OR poses a high risk for musculoskeletal injuries of the lower back, shoulder, and neck, with the increase in bariatric patients contributing to this.

Perioperative staff have the challenge of moving patients into supine, lithotomy, semi-prone, or prone positions, while accommodating various specialty operating room tables. Often safe patient handling technology is unavailable or not easily used with the equipment, resulting in manual handling of the patient and a greater likelihood of injuries.

The AORN Ergonomic Tool was published in 2011 to provide guidelines for technology use. It states: • Supine to supine patient transfers with patients <157 lbs., a friction-reducing or assistive device required (minimum four caregivers), and • Patients >157 lbs., a mechanical lift with supine sling, mechanical lateral transfer device, or air-assisted lateral transfer device required (three or four caregivers).

When choosing equipment, seek versatile devices to ensure use and efficacy. Following the AORN guidelines and using appropriate, multifunctional devices can help significantly decrease the risk of patient handling injuries for OR staff.

Sources: AORN J 93 (March 2011) 334-339. Published by Elsevier Inc. on behalf of AORN, Inc. doi: 10.1016/j.aorn.2010.08.025

Jaime Murphy Dawson, MPH, American Nurses Association’s senior policy advisor on occupation health and safety, agreed, saying ORs were hardly alone in this equipment shortage, despite the different options available.

Equipment is safer for the patient, who is at risk for being dropped or hurt when being moved by a nurse or two, she said, adding nurses are also less at risk for skeletal injuries if they have equipment to assist them. “We’re losing skilled, experienced members of the healthcare team because of these injuries,” she added.

Patients also report feeling more dignified when equipment is used, especially the heavier patients, she said. “Nurses are going to be a little bit nervous to move someone who’s a few 100 pounds, and I think patients can feel that,” she explained.

“They don’t want to hurt their nurses either.”

After the patient enters the recovery room, which means a few more new faces, the goal, of course, is to get them out the door and on their way home as soon as possible so they’re less susceptible to healthcare associated infections, Spruce said.

If they do stay in recovery for a few days, patient handling devices should be available to help them with daily tasks, like going to the bathroom, and get them back on their feet, Dawson said.

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PRODUCT SPOTLIGHT: Warming and Cooling

Bair Paws Flex Gown The 3M™ Bair Paws™ flex gown adds a new dimension to patient warming. With integrated 3M™ Bair Hugger™ upper and lower body blankets, the Bair Paws flex gown offers broad clinical flexibility in a practical, economic package – one single-use warming solution that can cover nearly any perioperative warming requirement. www.3M.com

FluidSmart The Thermedx® FluidSmart™ System is an endoscopic solution for Gynecology, Urology, and Orthopedic irrigation applications. It provides advanced technology for fluid delivery and ondemand fluid warming (up to 40°C). This system features real-time fluid deficit measurement, simple set up and is intuitive to operate. “On the fly” fluid bag and suction canister changes allow for uninterrupted use. www.thermedx.com

Streamline Patient Warming from admission to discharge Warm fluids and blankets in bulk, then keep the fluids warm right in the OR with ivNow® Improve processes: • Efficiently warm patients from admission to discharge • Warm fluids in a cabinet and keep them warm at the point of use with the space-saving ivNow warmer ivNow increases regulatory compliance: • Display actual temperature of every bag • Records the shelf life of every bag ivNow saves money: • Reduce disposable costs while warming 20-140 liters of fluid over 12 hours Increase reimbursements: • Reduce SSIs and time spent in the PACU • Improve patient satisfaction surveys & clinical outcomes

er fluid warm ivNow-3 IV

EC1730BL combination warmer DC400L fluid warmer

Enthermics Medical Systems ISO 13485:2003 Certified | 1-800-862-9276 | www.enthermics.com

PRODUCT SPOTLIGHT: Warming and Cooling

Titan Series Blanket Warming Cabinets Enthermics’s newest Titan Series blanket warmers are available with zone heating. The energy-efficient WarmSafe zone heating system monitors all interior surface temperatures and balances heat throughout the cabinet, ensuring each blanket is warm with the heated shelves and panels. www.enthermics.com

Therapeutic Hypothermia Therapeutic Hypothermia takes temperature management to the next degree by prescribing precise temperatures in order to manage the metabolic functions of the body.

Blanketrol® III hyper-hypothermia system offers programmable body temperature regulation while still keeping the control in the hands of the caregiver. www.cszmedical.com

The average patient loses 3C during anesthesia1 CSZ offers mulitple modalities to help prevent temperature loss and improve your patients’ outcome by keeping your patients normothermia before, during and after surgery. Whether you are looking for convective, conductive or resistive warming solutions, we have them all.

Convective Warming

Conductive Warming

Resistive Warming

WarmAir® & FilteredFlo®

Norm-O-Temp® & Gelli-Roll®

SurfaceTemp®

www.cszmedical.com/or

1. Sessler D, Todd M. Perioperative heat balance. Anesthesiology 2000; 92(2):578-596. #10185

Anesthesiology

Changes Could Create Better Outcomes ASA offers methods for anesthesiologists to gain a competitive edge

by Rebecca Rudolph, editor

A

nesthesiologists are part of the evolving healthcare world where the concept of their positions remain the same, but the everyday tasks surrounding it change.

Healthcare legislation and its corresponding marketplace are driving two big focuses – practice evaluation and increasing the quality of patient care.

Data-Driven Care About the same time as the Patient Protection and Affordable Care Act was signed into law, the Anesthesiology Clinical Institute launched the Qualified Clinical Data Registry. This resource was designed for healthcare workers to compare notes about patient outcomes and facility approaches. “This has been used as a benchmark, to see how well you’re delivering care, what the variation of care may be within your practice, how you compare to others, (and) opportunities for improvement,” Dr. J.P. Abenstein, president of the American Society of Anesthesiologists (ASA), said.

ASA later took the lead of this data repository.

He explained the accumulated data shows surgical teams if there are variations in their care compared to other facilities. “People delivering healthcare don’t want to be an outlier,” he explained. These variations include: case length, recovery time, type of care, anesthesia administered and more, he said.

As an anesthesiologist, he was one example of how data could change an approach. He works with open heart surgery patients and commonly used medazylyn on patients.

When he was comparing his results to other cases, Abenstein noticed this drug significantly increased everyone’s mortality rates when used on elderly patient with sycosis. “With the data we’ve been gathering, we’ve pretty much stopped using medazlyien on the elderly because of this complication we were unaware of. Through this ongoing gathering of information, examining it in the context of how patients do and then adjusting our practices, (we can) improve the care we deliver to patients,” he said.

Another example is pain management. “What we’ve seen with different approaches to pain, like multimodal and decreasing the amount of narcotics we give, is patients have less pain and can get out of bed sooner,” Abenstein said.

Since the data is based off of patient records, it’s normally accurate with minimal human error, he said.

26 July/August | 2015 | www.SurgicalProductsMag.com

Perioperative Surgical Home Abenstein said this data archive could increase efficiencies in care, but ASA is pushing healthcare facilities to consider another option to increase the quality of patient care too – the Perioperative Surgical Home (PSH). Basically, it’s an extended, more comprehensive version of the Enhanced Recovery After Surgery (ERAS) Program.

Abenstein suggests, as the healthcare industry turns more into a market place, PSH will give facilities a competitive edge. “We’re arguing that by delivering a higher quality of care at a lower cost, by definition, you’re more competitive,” Abenstein said.

Instead of thinking of the procedural period starting the day of surgery, the PSH starts from the time the patient’s surgery is scheduled to 30 days after they’re discharged from the recovery room. Care is communicated with a big picture focus involving all team members, meaning the silos of care have been broken down, he said. The anesthesiologist will take the lead, making sure the patient, surgical team and others are aware of the patient’s situation and what needs to be done, he explained.

In the perioperative process, anesthesiologists would lead consultations, selectively test patients for potential risks and help patients reduce risk by encouraging behavioral changes before surgery.

The day of surgery, the patient would be rotated through a three-station unit including a perioperative preparing room, the OR and an early recovery room. The anesthesiologist would stay with the patient throughout their experience, moving them through each step. Ideally, this means the three main factors for delay – patients, the system and practitioners – would be coordinated.

Following the procedure, anesthesiologists would work with patients to implement the ERAS components. When patients leave the facility, the anesthesiologist continues care through follow up appointments.

While this means more work for the anesthesiologist, Abenstein said the cost to the system hasn’t increased because of the reduced complications. “It really depends on how you account for these costs to tease out if there’s cost savings or cost increase,” he said.

So far, about 50 United States facilities have incorporated certain areas of the PSH and are reporting savings, Abenstein said.

Anesthesiology

Changes and Consistencies

by Rebecca Rudolph, editor Just like other areas of medicine are evolving, anesthesiologists are experiencing changes, but also consistencies. Julie Anderson, general manager of Sharn Inc., pointed out a couple.

more overweight, there’s new challenges in establishing an airway. “I think the appetite for less traumatic devices continues to be strong, because the population is getting more challenging,” Anderson said.

Two Changes:

Two Consistencies:

1. Demand for Disposables The healthcare industry is being pushed to use more disposables after cases of improper repurposing resulted in patient infection, causing increased scrutiny from organizations, such as The Joint Commission, she said. “The goal is patient safety and reduced risk of infection, and no stone goes unturned it seems,” she observed. For anesthesiologists, this means reusable instruments, such as laryngoscope blades and handles, are replaced with disposable alternatives, despite environmental and budget concerns, she explained.

“Disposables offer the logical solution but require a shift in thinking and may take some getting used to.”

2. Patients are typically older and larger.

As the United States patient population gets older and

1. Airway products are still in demand.

“Airway management is one of the most important things an anesthesiologist does,” she said. As a result, there is an array of options for facilities to use. Video-assisted airway management options are extremely popular, just like any other video-related OR product, as are adjunct devices, she said.

2. Suppliers and professionals need to work together.

“It’s important to keep a dialogue open between the clinical community and industry side of the community – we have to be partners,” Anderson said. If there’s a steady flow of conversation and feedback, she said suppliers can support needs and trends with adequate products. “We help to develop the instruments and tools that enhance their practice, so their feedback and interaction with us, is really important."

Addressing patient safety

with innovation.

EyeGard™ The cleaner, gentler, safer way to protect your patient’s eyes during surgery.

FlexCPose™ Moldable, non-skid positioner for optimal airway management.

Visit us at www.Sharn.com Call 800-325-3671

Fax 813-886-2701 www.SurgicalProductsMag.com | July/August | 2015 27

Infection Control Resource Guide DISPOSABLE PRODUCTS Absorbable Antibacterial Envelopes Medtronic TYRX, Inc. Junction, NJ

Absorbent Mats Ansell Iselin, NJ Aspen Surgical, a Hill-Rom Company Caledonia, MI Breck Surgical Products, LLC Reno, NV Creative Foam Corporation Fenton, MI Ecolab St. Paul, MN Let’s Gel Austin, TX MD Technologies, Inc. Galena, IL Multisorb Technologies Buffalo, NY

Drapes, Other 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Cardinal Health Dublin, OH David Scott Company Framingham, MA Ecolab St. Paul, MN Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Lac-Mac London, ON MD Technologies, Inc. Galena, IL Tronex Healthcare Mount Olive, NJ David Scott Company Framingham, MA

Goggles/Shields/Eyeware Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Medisafe America Tampa, FL Palmero Health Care Stratford, CT SHARN, Inc. 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Fax: 813-886-2701 www.sharn.com mailbox@sharn.com

Waste Fluid Control Products

Surgimark 1703 Creekside Loop # 110 Yakima, Washington 98902-4875 Phone: 800-228-1186 Fax: 509-965-4852 www.surgimark.com/ custserv@surgimark.com

Needle Disposal Units Kapp Surgical Cleveland, OH Medi-Dose, Inc./EPS, Inc. 70 Industrial Dr., Ivyland, PA 18974 Phone: 215-396-8600 Fax: 215-396-6662 www.medidose.com Swan Valley Medical Bigfork, MT

Spill Kits Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com

Waste Reducers/Solidifiers Allen Medical Systems, Acton, MA Ansell Iselin, NJ Ecolab St. Paul, MN Multisorb Technologies Buffalo, NY Stryker Kalamazoo, MI

HAND HYGIENE Dispensers- Soap, Sanitizer Becton Dickinson 75 N. Fairway Dr., Vernon Hills, IL 60061 Phone: 800.523.0502 ext 3576 Fax: 855.329.6985 www.carefusion.com/medical-products/ infection-prevention/skin-preparation/ DebMed, Charlotte, NC Ecolab, St. Paul, MN Gojo, Akron, OH Medline, Katy, TX

Surgical Scrub 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Ecolab, St. Paul, MN

Allen Medical Systems, Acton, MA Aspen Surgical, a Hill-Rom Company Caledonia, MI Cardinal Health Dublin, OH Creative Foam Corporation Fenton, MI Ecolab St. Paul, MN MD Technologies, Inc. Galena, IL Multisorb Technologies Buffalo, NY Stryker Kalamazoo, MI Surgimark 1703 Creekside Loop # 110 Yakima, Washington 98902-4875 Phone: 800-228-1186 Fax: 509-965-4852 www.surgimark.com/ custserv@surgimark.com Zimmer Inc. Warsaw, IN

Surgical Hand Antiseptic

DISPOSAL PRODUCTS

PATIENT INFECTION CONTROL

General Waste Disposal Products

Patient Skin Prep Products

Ecolab St. Paul, MN MD Technologies, Inc. Galena, IL Multisorb Technologies Buffalo, NY

3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Becton Dickinson 75 N. Fairway Dr., Vernon Hills, IL 60061 Phone: 800.523.0502 ext 3576 Fax: 855.329.6985 www.carefusion.com/medical-products/ infection-prevention/skin-preparation/ GOJO, Akron, OH Steris, Mentor, OH

INFECTION CONTROL MONITORS Absorbable Antibacterial Envelopes Medtronic TYRX, Inc. Junction, NJ

3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention

Aspen Surgical, a Hill-Rom Company Caledonia, MI Becton Dickinson 75 N. Fairway Dr., Vernon Hills, IL 60061 Phone: 800.523.0502 ext 3576 Fax: 855.329.6985 www.carefusion.com/medical-products/ infection-prevention/skin-preparation/ Clorox Professional Products Company Oakland, CA Covidien Mansfield, MA Medtronic TYRX, Inc. Junction, NJ

Suction Tools Millennium Surgical Corp 822 Montgomery Ave #205, Narbeth, PA 19072 Phone: 800-600-0428 Fax: 800-600-0429 info@millenniumsurgical.com www.surgicalinstruments.com Surgimark 1703 Creekside Loop # 110 Yakima, Washington 98902-4875 Phone: 800-228-1186 Fax: 509-965-4852 www.surgimark.com/ custserv@surgimark.com

Surgical Prep Applicators Becton Dickinson 75 N. Fairway Dr., Vernon Hills, IL 60061 Phone: 800.523.0502 ext 3576 Fax: 855.329.6985 www.carefusion.com/medical-products/ infection-prevention/skin-preparation/ Covidien Mansfield, MA Medtronic TYRX, Inc. Junction, NJ

Temperature Management 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionpreventi Entermics Medical Systems PO Box 443, Menomonee Falls, WI 53052 Phone: 800-862-9276 Fax: 262-251-7067 generalinfo@enthermics.com www.entermics.com Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com MAC Medical, Inc. 325 West Main Street, Belleville, IL 62220 Phone: 877-828-9975 Fax: 618-476-3337 sales@macmedical.com SHARN, Inc. 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Fax: 813-886-2701 www.sharn.com mailbox@sharn.com

Topical Wound Treatment Products Care-Tech® Laboratories, Inc. St. Louis, MO Mölnlycke Health Care Norcross, GA Zimmer Surgical, Inc. 200 West Ohio Ave. Dover, OH Phone: 800-321-5533 www.surgical.zimmer.com

Wound Cleaning Care-Tech® Laboratories, Inc. St. Louis, MO

28 July/August | 2015 | www.SurgicalProductsMag.com

Surgimark 1703 Creekside Loop # 110 Yakima, Washington 98902-4875 Phone: 800-228-1186 Fax: 509-965-4852 www.surgimark.com/ custserv@surgimark.com

Wound Closure

Richard Wolf Medical Instruments Corporation Vernon Hills, IL SHARN, Inc. 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Fax: 813-886-2701 www.sharn.com mailbox@sharn.com Spectrum Surgical Instruments Corp. Stow, OH Trocar Sweep Arlington, TX

Arc Overseas Sialkot Amd-Ritmed, Inc. Tonawanda, NY Aspen Surgical, a Hill-Rom Company Cleaning Solutions Caledonia, MI Clorox Professional Products Company CONMED- Cardiology & Critical Care Utica, NY Oakland, CA Covalon Technologies Ltd. Mississauga, ON Crosstex/SPSmedical Covidien Mansfield, MA 6789 W. Henrietta Rd., Rush, NY 14543 Centurion Medical Products Williamston, MI Phone: 800-722-1529 Fax: 585-359-0167 Incisive Surgical, Inc. www.spsmedical.com 14405 21st Ave. North, Suite 130 info@spsmedical.com Plymouth, MN 55447 Phone: (952) 591-2543, ext. 018 Ecolab St. Paul, MN www.insorb.com Haemo-Sol Baltimore, MD Mölnlycke Health Care Norcross, GA Instrument Specialists, Inc. Boerne, TX InstruSafe/Summit Medical, Inc. Saint Paul, MN SHARN, Inc. Medisafe America Tampa, FL 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Palmero Health Care Stratford, CT Fax: 813-886-2701 Spectrum Surgical Instruments Corp. Stow, OH www.sharn.com STERIS Corporation Mentor, OH mailbox@sharn.com Flash Sterilization Products Tronex Healthcare Mount Olive, NJ Millennium Surgical Corp/ Wound Drainage Systems Surgicalinstruments.Com Aspen Surgical, a Hill-Rom Company 822 Montgomery Ave., #205 Caledonia, MI Narberth, PA 19072 Cardinal Health Dublin, OH Phone: 800-600-0428 Fax: 800-600-0429 Creative Foam Corporation Fenton, MI www.

Surgimark surgicalinstruments.

1703 Creekside Loop # 110 com Yakima, Washington 98902-4875 STERIS Corporation Phone: 800-228-1186 Mentor, OH Fax: 509-965-4852 www.surgimark.com/ Instrument Washers/ custserv@surgimark.com

Decontaminators

Zimmer Surgical, Inc. 200 West Ohio Ave. Dover, OH Phone: 800-321-5533 www.surgical.zimmer.com

STERILIZATION/CLEANING EQUIPMENT

Medisafe America Tampa, FL Olympus America, Inc. Center Valley, PA STERIS Corporation Mentor, OH

Autoclaves

Scrub Sinks

Skytron Grand Rapids, MI STERIS Corporation Mentor, OH

Bryton Corporation Indianapolis, IN Future Health Cleaning Brushes Concepts, Inc. Aspen Surgical, a Hill-Rom Company Sanford, FL Caledonia, MI KTW Medical CONMED - Endoscopic Technologies Utica, NY Mooresville, NC Cygnus Medical Branford, CT MAC Medical, Inc. Healthmark 325 West Main Street, 33671 Doreka Drive Fraser, MI 48026 Belleville, IL 62220 Phone: 800-521-6224 Phone: 877-828-9975 Fax: 586-491-2113 Fax: 618-476-3337 msmith@hmark.com sales@macmedical. www.hmark.com com Instrument Specialists, Inc. Boerne, TX STERIS Corporation Key Surgical, Inc. Eden Prairie, MN Mentor, OH Medisafe America Tampa, FL Sterilization Millennium Surgical Corp Containers 822 Montgomery Ave #205, Narbeth, PA Healthmark 19072 Industries Company, Phone: 800-600-0428 Inc. Fax: 800-600-0429 33671 Doreka, info@millenniumsurgical.com Fraser, MI 48026 www.surgicalinstruments.com Phone: 586-774-7600 OrthoMed, Inc. Tigard, OR Fax: 586-491-2113 Palmero Health Care Stratford, CT www.hmark.com www.SurgicalProductsMag.com | July/August | 2015 29

InstruSafe/Summit Medical, Inc. Saint Paul, MN Mediflex Surgical Products Islandia, NY Richard Wolf Medical Instruments Corporation Vernon Hills, IL

Sterilization Solutions 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Instrument Specialists, Inc. Boerne, TX

Sterilizer Testing 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention JG&A Metrology Center Detroit, MI

Infection Control Resource Guide Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Cygnus Medical Branford, CT Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com

Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com STERIS Corporation Mentor, OH Tru-D Memphis, TN Xenex Disinfection Services 121 Interpark, Ste. 104, San Antonio, TX 78216 Phone: 800-553-0069 Fax: 210-855-3721 www.xenex.com

Sterilizers

Wipes

3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Clorox Professional Products Company Oakland, CA Future Health Concepts, Inc. Sanford, FL STERIS Corporation Mentor, OH Xenex Disinfection Services 121 Interpark, Ste. 104, San Antonio, TX 78216 Phone: 800-553-0069 Fax: 210-855-3721 www.xenex.com

SHARN, Inc. 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Fax: 813-886-2701 www.sharn.com mailbox@sharn.com

SHARPS SAFETY

Millennium Surgical Corp/ Surgicalinstruments.Com 822 Montgomery Ave., #205 Narberth, PA 19072 Phone: 800-600-0428 Fax: 800-600-0429 www.surgicalinstruments.com Haemo-Sol Baltimore, MD Medisafe America Tampa, FL Spectrum Surgical Instruments Corp. Stow, OH STERIS Corporation Mentor, OH

Sterilization Wraps

Needlestick Prevention Products Ansell Iselin, NJ Aspen Surgical, a Hill-Rom Company Caledonia, MI Cardinal Health Dublin, OH Centurion Medical Products Williamston, MI Incisive Surgical, Inc. 14405 21st Ave. North, Suite 130 Plymouth, MN 55447 Phone: (952) 591-2543, ext. 018 www.insorb.com Kapp Surgical Cleveland, OH Sol-Millennium Medical, Inc. Lawrenceville, GA

Sharps Disposal Products Ansell Iselin, NJ Centurion Medical Products Williamston, MI Mesaad & Co. Sialkot

OR TURNOVER Room Sterilization-UV/Flash American Ultraviolet, Lebanon, IN Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Haemo-Sol Baltimore, MD Instrument Specialists, Inc. Boerne, TX Medisafe America Tampa, FL Millennium Surgical Corp/ Surgicalinstruments.Com 822 Montgomery Ave., #205 Narberth, PA 19072 Phone: 800-600-0428 Fax: 800-600-0429 www.surgicalinstruments.com Spectra254 Danbury, CT

Detergents and Disinfectants Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com

Ultrasonic Cleaning Units

Ultrasound Disinfectant Detergents

Encompass Group, LLC McDonough, GA Tronex Healthcare Mount Olive, NJ

Shoes, Non-Conductive Calzuro.com Plain City, OH

Cut-Resistant Gloves Ansell Iselin, NJ

Latex Gloves Ansell Iselin, NJ Cardinal Health Dublin, OH Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Spectrum Surgical Instruments Corp. Stow, OH Tronex Healthcare Mount Olive, NJ

Nitrile/Synthetic Gloves Ansell Iselin, NJ Cardinal Health Dublin, OH Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Spectrum Surgical Instruments Corp. Stow, OH Tronex Healthcare Mount Olive, NJ

Orthopedic Gloves Ansell Iselin, NJ Cardinal Health Dublin, OH

Powder Free Exam Gloves Ansell Iselin, NJ Tronex Healthcare Mount Olive, NJ

Powder Free Surgical Gloves Ansell Iselin, NJ Cardinal Health Dublin, OH

Surgical Gloves

Medisafe America Tampa, FL

Ansell Iselin, NJ Cardinal Health Dublin, OH

ULTRAVIOLET DISINFECTION

Surgical Helmets

Instrument Disinfection

Zimmer Surgical, Inc. 200 West Ohio Ave. Dover, OH Phone: 800-321-5533 www.surgical.zimmer.com

American Ultraviolet Lebanon, IN Spectra254 Danbury, CT STERIS Corporation Mentor, OH Tru-D Memphis, TN Xenex Disinfection Services 121 Interpark, Ste. 104, San Antonio, TX 78216 Phone: 800-553-0069 Fax: 210-855-3721 www.xenex.com

Room Disinfection American Ultraviolet Lebanon, IN Spectra254 Danbury, CT STERIS Corporation Mentor, OH Tru-D Memphis, TN Xenex Disinfection Services 121 Interpark, Ste. 104, San Antonio, TX 78216 Phone: 800-553-0069 Fax: 210-855-3721 www.xenex.com

APPAREL

Vinyl Gloves Ansell Iselin, NJ Tronex Healthcare Mount Olive, NJ

GOWNS/SCRUBS Antimicrobial OR Scrubs Cardinal Health Dublin, OH Encompass Group, LLC McDonough, GA undORwear Buffalo Grove, IL

Aprons Cardinal Health Dublin, OH Palmero Health Care Stratford, CT Tronex Healthcare Mount Olive, NJ

Isolation Gowns Amd-Ritmed, Inc. Tonawanda, NY Encompass Group, LLC McDonough, GA Tronex Healthcare Mount Olive, NJ

O.R. Disposable Gowns Cardinal Health Dublin, OH

PERSONALPROTECTIONEQUIPMENT(PPE) O.R. Reusable Gowns Shoe Covers Amd-Ritmed, Inc. Tonawanda, NY 30 July/August | 2015 | www.SurgicalProductsMag.com

Encompass Group, LLC McDonough, GA Lac-Mac London, ON

Patient Gowns 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Cardinal Health Dublin, OH Encompass Group, LLC McDonough, GA Tronex Healthcare Mount Olive, NJ

Scrub Suits Encompass Group, LLC McDonough, GA Tronex Healthcare Mount Olive, NJ undORwear Buffalo Grove, IL

MASKS/EYEWEAR Face Masks 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Amd-Ritmed, Inc. Tonawanda, NY Cardinal Health Dublin, OH Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com

28 10 5

Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Key Surgical, Inc. Eden Prairie, MN Tronex Healthcare Mount Olive, NJ

Glasses

Face Shields

Isolation Masks

Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Encompass Group, LLC McDonough, GA Healthmark 33671 Doreka Drive Fraser, MI 48026 Phone: 800-521-6224 Fax: 586-491-2113 msmith@hmark.com www.hmark.com Medisafe America Tampa, FL Palmero Health Care Stratford, CT Qosina Edgewood, NY SHARN, Inc. 4517 George Rd Ste 200, Tampa, FL 33634 Phone: 800-325-3671 Fax: 813-886-2701 www.sharn.com mailbox@sharn.com Spectrum Surgical Instruments Corp. Stow, OH

Amd-Ritmed, Inc. Tonawanda, NY Tronex Healthcare Mount Olive, NJ

Cardinal Health Dublin, OH Encompass Group, LLC McDonough, GA Palmero Health Care Stratford, CT

Goggles Medisafe America Tampa, FL Palmero Health Care Stratford, CT

Surgical Masks 3M Infection Prevention 3M Center, St. Paul, MN Phone: 800.228.3957 www.3M.com/infectionprevention Amd-Ritmed, Inc. Tonawanda, NY Ansell Iselin, NJ Crosstex/SPSmedical 6789 W. Henrietta Rd., Rush, NY 14543 Phone: 800-722-1529 Fax: 585-359-0167 www.spsmedical.com info@spsmedical.com Tronex Healthcare Mount Olive, NJ

DAY reuse period, twice as long as 14 day OPA’s MINUTE manual disinfection time at 20°C minimum MINUTE AER disinfection time at 25°C

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www.SurgicalProductsMag.com | July/August | 2015 31

Kills more bacteria than povidone-iodine and DuraPrep.™ End of story.

Accept nothing less than the powerful performance of ChloraPrep® skin antiseptic.

There’s no den ing the evidence. ChloraPrep® is more effective than both 1,2,3

povidone-iodine and DuraPrep at eliminating microorganisms on the skin.

And unlike iodine-based skin preps

ou can be confident that ChloraPrep

Scan here to see how ChloraPrep performs compared to the competition.

will maintain antimicrobial effectiveness for at least 48 hours.4,5 References: 1. Saltzman MD, Nuber GW, Gr zlo SM, Marecek GS, Koh JL. Efficac f surgical preparation solutions in shoulder surger . J Bone Joint Surg Am. 2009;91(8):1949–1953. 2. Ostrander RV, Botte MJ, Brage ME. Efficac f surgical preparation solutions in foot and ankle surger . J Bone Joint Surg Am. 2005;87(5):980–985. 3. Adler MT, Brigger KR, Bishop KD, Mastrobattista JM. Comparison of bactericidal properties of alcohol-based chlorhexidine versus povidone-iodine prior to amniocentesis. Am J Perinatol. 2012;29(6):455–458. Epub 2012 Mar 7. 4. Denton GW. Chlorhexidine. In: Block SS. Disinfection, Sterilization, and Preservation. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2001:321–336. 5. Hibbard JS. Anal ses comparing the antimicrobial activit nd safet f current antiseptic agents: a review. J Infus Nurs.

2005;28(3):194–207.

chloraprep.com/compare | 800.523.0502 | facebook.com/CareFusionIP

© 2014 CareFusion Corporation or one of its subsidiaries. All rights reserved. DuraPrep (Iodine Povacrylex [0.7% available Iodine] and IPA, 74% w/w) is a trademark of 3M. ChloraPrep is a registered trademark of CareFusion Corporation or one of its subsidiaries. ADV-KILLS1212QR

SPOTLIGHT ON: Endoscopic ESP Nominees Products

Excellence in Surgical Products Award Nominees For the seventh year, Surgical Products is recognizing innovative products released to the surgical industry. In this issue and the next, nominations for these awards will be published, in addition to being featured on the Surgical Products website www.SurgicalProductsMag.com and its daily newsletter Today is Surgery. After all the nominations have been made, readers pick the winners, which will be featured in the November/ December issue of Surgical Products.

April Surgical Products LLC’s Anesthesia Face Wrap

CareFusion’s ClipVac Pre-Surgical Hair Removal System

Category: Safety Briefly describe the product: The Anesthesia Face Wrap is a brand new product developed by a Nurse Anesthetist for patient safety in the operating room. Optimal face protection for patient safety in supine and beach-chair position.

Meticulously designed to view facial structures and made out of two layers of soft polyurethane foam that tear easily for airway emergency. Eliminate makeshift solutions and make the Anesthesia Face Wrap the universal standard of care for the safety of our patients.

Describe what sets this apart from others available on the market: The Anesthesia Face Wrap protects patients from unwanted pressure and weight placed on the face, including things like surgical instruments, provider elbows and robotic arms. www.aprilsurgical.com

Category: Infection Control Briefly describe the product: ClipVac®, the newest addition to our market-leading surgical clippers helps provide a complete surgical hair removal system and eliminates the need for extra cleanup with messy tape or mitts. ClipVac vacuum captures an average 98.5 percent of hair and airborne contaminants at the source, helping reduce the potential risk of complications. ClipVac conveniently attaches to your CareFusion surgical clippers so you can clip hair and clean it up – all in one step.

Describe what sets this apart from others available on the market: CareFusion surgical clippers and ClipVac® work together to provide a complete, pre-surgical hair removal system that saves valuable patientprep time and helps reduce the risk of complications for patients. www.carefusion.com

Cardinal Health’s Endoscopy Kits Category: Infection Control Products Briefly describe the product: Cardinal Health endoscopy kits support the Society of Gastroenterology Nurses and Associates (SGNA), American Society for Gastrointestinal Endoscopy (ASGE) and multi-society recommendations on infection control. Kits include products that comply with SGNA’s Standards of Infection Control in Reprocessing of Flexible Gastrointestinal Endoscopes by supporting bedside cleaning of the endoscope, as well as cleaning in the reprocessing area.

The Multi-Purpose Scope Transport Bag, with drawstrings and bio-hazard label, allows for bedside cleaning and safe transport of the endoscope to reprocessing. The ScopeValet™ Eco-Bedside Cleaning Kit, with wide-mouth tray and lid, is designed to prevent spillage of the enzymatic solution during preparation.

Describe what sets this apart from others available on the market: Cleaning kits contain a biodegradable plant-based container. Brushes are designed with a rounded tip to help prevent damage to inside channels of scope during cleaning. www.cardinal.com www.SurgicalProductsMag.com | July/August | 2015 33

ESP Nominees

Action Product’s Long Positioning Strap

3M’s Skin and Nasal Antiseptic

Category: Tables, Positioning and Accessories Briefly describe the product: The longest continuous strap on the market (90 inches) is made for positioning your patients and minimizing movement on the operating room table. The Akton® polymer gel protects skin from pressure and shear complications. Welded seams and four-way stretch microberesistant fabric, make this a must have for any operating room.

Radiolucent and MRI safe. Hook and loop attachments secure the strap to standard tables. Average size strap available. This strap is not meant to restrain patients.

Describe what sets this apart from others available on the market: Key Benefits: • Akton® polymer protects skin from skin complications • Welded, fluid-proof seams and microbe-resistant fabric • Radiolucent, MRI safe • Adjustable from large to Bariatric • Standard size available www.actionproducts.com

Category: Infection Control Briefly describe the product: 3M™ Skin and Nasal Antiseptic (Povidone-Iodine Solution 5 percent w/w [0.5 percent available iodine] USP) Patient Preoperative Skin Preparation is designed to quickly and effectively reduce S. aureus colonization in the nares, giving healthcare providers confidence their patients are entering surgery with a reduced risk of infection. A film-forming polymer in the solution enables the active ingredient to remain in the nares and efficiently coat and adhere to the nares where bacteria reside. Packaged in an easy-to-open 4 mL bottle with sterile swabs, the swabs are designed to fit comfortably into nostrils while providing good coverage of the nares with minimal dripping or running.

Describe what sets this apart from others available on the market: 3M™ Skin and Nasal Antiseptic is designed to work within the preoperative process to quickly reduce S. aureus colonization in the nares. www.3m.com

ESP Nominees

INSORB’s Absorbable Subcuticular Skin Stapler

KMI Surgical’s EyeGard Category: Safety Briefly describe the product: The EyeGard eyepatch is specifically designed to seal the patient’s eyelid during surgery, providing simple and effective protection from corneal abrasion. Corneal abrasions are the most common eye injury and can be extremely painful. The most frequent cause is exposure keratopathy and incidence estimates are as high as 44 percent for unprotected eyes but <.5 percent when the eyes are sealed closed. EyeGard is shaped to fit the eye, is translucent and is made with a unique material that is breathable yet provides a moisture barrier.

EyeGard is gentle on delicate skin around the eye and on eyelashes. Also available for pediatrics.

Describe what sets this apart from others available on the market: EyeGard is a cleaner alternative to tape reducing infection risks, and preventing extended stays due to skin tears, reddened or bruised skin or, worse, abrasions. www.kmisurgical.com

Ruhof Healthcare Corp.’s Aquabrush Category: Infection Control Briefly describe the product: The Ruhof Aquabrush is a rechargeable, completely submersible surgical instrument cleaning brush, which eliminates manual scrubbing for easier, more efficient instrument reprocessing.

The AquaBrush kit comes with both large and small disposable brush heads to accommodate various instrument sizes, two lithium batteries and fast charger. Lightweight and ergonomically designed with a non-slip pistol grip and push button control, the Aquabrush fits comfortably in your hand. ruhof.com www.SurgicalProductsMag.com | July/August | 2015 35

Category: Surgical Instruments Briefly describe the product: The INSORB|30 Absorbable Subcuticular Skin Stapler is a revolutionary new patient-centric, cost-effective, rapid skin closure modality. The INSORB Stapler places an absorbable staple completely underneath the top layer of skin to close surgical incisions. The INSORB Staple is essentially absorbed within 90 to 120 days.

The INSORB Stapler combines the comfort, cosmesis and convenience of absorbable suture with the speed of a metal skin stapler, while eliminating percutaneous insult of metal staples and post-operative metal staple removal. Over 1,500,000 INSORB Staplers have been sold throughout the world; over 100,000 US C-sections were closed with an INSORB Stapler (est.) last year.

Describe what sets this apart from others available on the market: The INSORB Absorbable Subcuticular Skin Stapler is the only device commercially available that places an absorbable staple completely underneath the epidermis to close surgical incisions. www.insorb.com

ESP Nominees

Toff Colney International Inc.’s Flex C Pose Surgical Headrest and Positioner Category: Tables, Positioning and Accessories Briefly describe the product: The Flex C Pose uses familiar bean bag technology and a smart design as a template for an exciting new product. It's slightly smaller than a bed pillow and weighs about 10 pounds.

It is made from waterbed film and is extremely durable and easy to clean. It has a valve for applying suction or entraining air depending on the firmness desired. It also has a non-skid rubber bottom.

Describe what sets this apart from others available on the market: Flex C Pose is multi-functional and can be customized to every patient and surgical procedure.

Flexcpose.com

NOVA Surgical Light Source Category: Lighting Briefly describe the product: The NOVA is a hand held surgical light source powered by selfcontained batteries and has one button for controlling, Momentary or Latching, the three supper bright LED lights for improved illumination of the surgical site and one each Cut and Coag push buttons for controlling the output power of a standard electrical generators. Because the LEDs are battery powered, the NOVA can also be used as a portable light source without being connect to a Electrosurgical Generator.

Describe what sets this apart from others available on the market: NOVA Eliminates Shadows and Enhances Visualization in deep incisions in a device the surgeon already has in his hands and eliminates need for head lamps. www.pare-surgical.com

EndoChoice, Inc.’s Fuse Full Spectrum Endoscopy Generation 2 Category: Minimally Invasive Surgical Procedures Briefly describe the product: The Fuse® Full Spectrum Endoscopy® Generation 2 enables physicians to see more of the GI tract during procedures, and provides peace of mind in knowing you received the most advanced screening available. The Fuse Generation 2 colonoscopes feature three cameras at the tip providing your physician with a panoramic 330 degree view of the colon that is projected on a 4K Ultra HD curved display.

Describe what sets this apart from others available on the market: In a study published in The Lancet Oncology Fuse found 69 percent more pre-cancerous polyps and had a significantly lower “miss rate” than traditional endoscopes. www.endochoice.com/fuse

Cincinnati Surgical’s Retractable Safety Stitch Cutter Category: Safety Briefly describe the product: With the newly introduced Retractable Safety Stitch Cutter the blade can be retracted away and locked in place to avoid any potential sharps injuries. Functioning in the same fashion as our existing range of Retractable Safety Scalpels the Stitch Cutter has a yellow slider for easy recognition on the red handle.

This stainless steel blade is made out of high quality British steel and is available in sterile or non-sterile versions. This safety stitch cutter is easy to use and reduces the chance of sharps injury for both the user and the patient.

Describe what sets this apart from others available on the market: This Retractable Safety Stitch Cutter is the first of its kind in the US market. This innovative safety product is changing the stitch removal process. www.cincinnatisurgical.com 36 July | 2015 | |www.SurgicalProductsMag.com 36 July/August 2015 | www.SurgicalProductsMag.com

Now you can clip hair and clean it up—all in one step.

ClipVac,® the newest addition to our line of market-leading surgical clippers, vacuum captures an average 98.5 percent of hair and airborne contaminants at the source, eliminating the need for extra cleanup with messy tape or mitts and helping reduce the risk of complications for patients. Make pre-surgical hair removal a clean sweep.

Learn more at carefusion.com/ClipClean.

© 2015 CareFusion Corporation or one of its affiliates. All rights reserved. ClipVac, CareFusion and the CareFusion logo are trademarks or registered trademarks of CareFusion Corporation or one of its affiliates. SU5590

ESP Nominees

Frontier Medical Innovationsâ&#x20AC;&#x2122; GStirrup Category: Tables and Positioning Briefly describe the product: The GStirrup from Frontier Medical Innovations is a patient positioning tool that provides safety, stability and comfort to patientsâ&#x20AC;&#x2122; legs when in the lithotomy position. More procedures are now being done in the physicianâ&#x20AC;&#x2122;s office and the GStirrup was developed to address the need for in-office patient positioning. The GStirrup simply slides over current footrests to economically and efficiently provide support for patients when in the lithotomy position. If the physician would prefer the GStirrups to be immobile, simply slide the wedge into the boot opening and immobility will be achieved.

Describe what sets this apart from others available on the market: The GStirrup requires no tools or accessories for installation and reduces the risk of nerve damage that can sometimes result when using knee crutches. www.gstirrup.com

Trocar Incision Closure Device Reusable â&#x20AC;&#x201D; Cost Effective

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1-800-600-0428 www.surgicalinstruments.com/trocar-closure 38 July | 2015 | www.SurgicalProductsMag.com

Healthmarkâ&#x20AC;&#x2122;s Flexible Inspection Scope Category: Infection Control Briefly describe the product: The Flexible Inspection Scope provides high quality images of the inside of difficult to observe lumens, it is the perfect inspection tool. It includes a distal tip composed of a light source and camera lens at the end of a 50 cm, flexible shaft.

Designed for channels 3.2mm in diameter or larger, it provides perfect visualization of any potentially soiled tool. Software is included, which installs on Windows 7 & Window 8, and allows viewing and recording.

Paired with Healthmarkâ&#x20AC;&#x2122;s FlexibleArm, the Flexible Inspection Scope can be securely fastened and moved in numerous ways.

Describe what sets this apart from others available on the market: The Flexible Inspection Scope provides a remarkable clarity of image with a durability that allows you to inspect a wide variety of lumened medical devices. www.hmark.com

ESP Nominees

Buffalo Filter’ LaparoVue Visibility System Category: Minimally Invasive Surgical Products Briefly describe the product: Understanding a surgeon’s need to see clearly during laparoscopic surgery, LaparoVue is an all-in-one solution designed to take the complexity out of achieving optimal visualization. An easy to use, disposable multi-purpose device that warms, white balances, cleans and defogs, LaparoVue eliminates the necessity for multiple product purchases.

LaparoVue features a contoured, easy grip profile two ports, one for warming/white balancing and one for cleaning/defogging. Both ports can accommodate scopes ranging in size from 3 to 12 mm eliminating the need for a port size converter, and can be used simultaneously during surgery providing, greater efficiency and reducing surgery delays.

Describe what sets this apart from others available on the market: The detachable scope cradle safely and securely supports the scope, reducing tension on the lens and potential for damage. Built-in LED lights provide enhanced port visibility. www.buffalofilter.com

Measure the temperature department with ease

gSource’s gSilicone Rod Shears Category: Surgical Instruments Briefly describe the product: An instrument of “shear” genius! Shear 3 different rod diameters with one instrument.

• Double action design allows for ease in cutting three common rod diameter sizes - 4.5mm, 5.5mm and 6.35mm.

• Rods are sheared, leaving a smooth and clean surface rather than a sharp, jagged, burr-like surface common when using a standard pinching-type rod cutter.

• Biocompatible silicone handles help to prevent slippage and provide a secure, comfortable grip.

• Seven standard biocompatible silicone colors are available or a custom color of your choice.

• Available with and without detachable handles.

• High quality precision instrument made from German stainless steel.

Describe what sets this apart from others available on the market: Rods are sheared, leaving a smooth and clean surface rather than a sharp, jagged, burr-like surface common when using a standard pinching-type rod cutter. www.gsource.com

& humidity of your

TEMP-USB These two temperature and humidity data loggers are perfect for department rooms where temperature and humidity control is crucial.

TEMP-USB-TH Measures over 250,000 temperatures and humidity readings ranging from -22 to 176ºF and 0 to 100% relative humidity.

TEMP-USB-Tp Features dual temperature probes which can gather over 250,000 readings (-40 to 257ºF) via two separate probes.

Perfect for measuring the temperature of sinks, ultrasonic baths, warming cabinets, refrigerators and other applications where a probe is needed to measure the temperature.

HEALTHMARK INDUSTRIES CO. | 800 521 6224 | WWW.HMARK.COM www.SurgicalProductsMag.com | July | 2015 39

ESP Nominees

Stryker’s New Dual Flat Panel System stem Category: OR Equipment and Accessories Briefly describe the product: The Stryker Dual Flat at Panel System is an adaptable monitor mounting solution designed to simplify the complexities of hospital environments. ts. The ergonomic handle provides exceptional maneuverability bility and, through the use of proprietary ROME technology, the he system can be rotated more than 360° rotation without coming ming to a stop. This ensures that imaging monitors can be effortlessly ortlessly moved into position for the best procedural applications. tions. The frameless mount is also adjustable, ensuring that as monitor sizes and specifications continue to evolve, so will Stryker’s tryker’s Dual Flat Panel System.

Describe what sets this apart from others available on the market: The frameless and adjustable Stryker Dual Flat Panel System provides unmatched maneuverability and is designed to adapt to the evolving image-viewing needs of hospital environments. stryker-pdc.com

Kubtec’s MOZART Category: OR Equipment and Accessories Briefly describe the product: Kubtec’s MOZART with TomoSpec, which introduced the world to specimen radiography with 3D imaging capability for the OR, now comes standard with an exciting new feature for surgeons: an integrated high resolution optical camera. Optical images allow surgeons to make side-by-side comparison with tomosynthesis views right in the OR. Combined with Kubtec’s robust software tools, to enhance and annotate X-ray images, surgeons can see the orientation of the excised tissue to make the best decisions to verify margins and reduce re-excision rates.

Describe what sets this apart from others available on the market: The advanced capabilities of MOZART, with high-resolution optical camera, brings value to the OR, saving resources in time and cost, and improving quality of care. kubtec.com

No Mo Nausea Band Category: OR Equipment and Accessories Briefly describe the product: No Mo Nausea bands are the first and only combination medical device (wristbands) to prevent and treat active nausea and vomiting using acupressure and natural peppermint oil aromatherapy. Acupressure at the P6 point on the wrist targets receptors in the CTZ of the brain, preventing nausea through neuromodulation.

Peppermint oil infused directly into the band acts as a rescue antiemetic, immediately relieving nausea when smelled.

Highlights: • Latex-free • Drug-free • Side effect free • BPA-free • Fast-acting • Waterproof • Comfortable • Easy to use • Equivalent to 4mg of Zofran • Cost effective • Customizable • Increases patient satisfaction Describe what sets this apart from others available on the market: Similar products only have the acupressure component, or the aromatherapy component. The No Mo Nausea band combines the two into one (patent-pending) wristband. nomonausea.com

Patient Safety Gear Inc.’s PICC Line Sleeve Product Category: Safety Briefly describe the product: The PICC LINE SLEEVE is placed on the patient’s arm that has the PICC line inserted. It is worn on the forearm or slightly higher near the line dressing. It was designed at the request of several hospitals to alert staff that a PICC Line (PERIPHERALLY INSERTED CENTRAL CATHETER) is in place and to avoid taking blood pressures or starting an IV in that arm. Hospital satisfaction has been excellent! PICC Sleeves are available in regular and extra large sizes. New MID LINE Sleeve also available!

Describe what sets this apart from others available on the market: The first of its kind, the PICC Line Sleeve alerts staff with its bright orange color and bold white lettering, making it hard to miss. www.g-sleeve.com 40 July/August | 2015 | www.SurgicalProductsMag.com

ESP Nominees

LifeThreads’ Antimicrobial Scrubs

InstruSafe’s Instrument Protection Trays

Category: Apparel Briefly describe the product: LifeThreads, a life sciences company focused on infection control and management, offers a line of antimicrobial scrubs designed to act as an added layer of protection in healthcare facilities.

The garments are treated with an EPA-registered, zinc-based additive that inhibits the growth of bacteria on the fabric’s surface by 99.99 percent. They are also antifungal with odor control and feature fluid-barrier technology, repelling dangerous fluids that medical professionals encounter.

Made with a soft polyester-cotton blend, LifeThreads’ scrubs can be laundered using the same protocols as conventional equivalents with no impact to the antimicrobial characteristics for the life of the product.

Describe what sets this apart from others available on the market: LifeThreads produces the only medical apparel using the zinc-based additive, offering antimicrobial and antifungal protection with comfort, durability and costeffectiveness when compared to similar products. www.life-threads.com

Category: OR Equipment and Accessories Briefly describe the product: InstruSafe instrument protection trays protect and organize surgical instruments during the sterilization, transport, and storage processes. Each tray is FDA 510(k) cleared for a variety of sterilization cycles. Our trays are constructed of highly perforated aluminum with retractable handles and silicone feet. Instruments are secured by soft and durable silicone holders made to fit each specific instrument within the base and cover to provide 360 degrees of protection. Our fully customizable trays offer the potential to reduce instrument repair and replacement which are typically caused by mishandling of trays during their day-to-day use cycle.

Describe what sets this apart from others available on the market: InstruSafe trays are fully customized to virtually any instrument set and can be reconfigured at any time to accommodate changes in preference or needs. www.instrusafe.com

I made a change that makes our hospital safer for our patients and employees.

Kristin Vondrak, Vice President and Chief Quality Officer, Baptist Health System, Jacksonville, FL

Join Kristin as a Face of Change.

Peer reviewed published outcomes:

Baptist Health has continued to focus on enhancing quality and TM

patient safety by integrating Xenex Germ-Zapping Robots into their overall infection prevention strategy.

53% reduction in C. diff infection rates.1 57% reduction in MRSA infection rates.2 100% elimination of VRE in isolation rooms.3

Xenex Robots are the only UV disinfection technology shown in peer reviewed published studies to reduce hospital acquired infections (HAIs).

xenex.com | 888 979 7438 | @XenexDisinfect

1. Levin J, et al., Cooley Dickinson in AJIC 2013, 41:746-748. 2. Simmons S, et al., Cone Health System in JIP 2013. 3. Stibich M, et al., M.D. Anderson Cancer Center in ICHE 2011, 32:286-288.

ESP Nominees

NICO BrainPath Category: Surgical Instruments Briefly describe the product: NICO BrainPath is part of a unique neurosurgical approach that provides atraumatic access to brain abnormalities by navigating through the delicate folds and fiber tracts called the sulci. The BrainPath enters the brain through an opening smaller than a dime. Once at the location of the abnormality, the obturator is removed from the sheath, leaving the sheath in place to create a corridor through which the surgeon operates. Surgeons using BrainPath are not required to cut through the brain’s white matter – tissue responsible for cognitive and functional responses – to reach the abnormality.

Describe what sets this apart from others available on the market: BrainPath enters the brain through the sulci to reach the abnormality. Existing tools require surgeons to cut through the white matter. www.niconeuro.com

Xenex’s Germ-Zapping Robots Category: Infection Control Briefly describe the product: Xenex's patented pulsed xenon Full Spectrum UV room disinfection system is a pesticidal device used for the advanced cleaning of healthcare facilities. Xenex Germ-Zapping Robots™ provide a safe environment for patients by significantly reducing bacteria and pathogen load in an environmentally friendly way, using mercury-free xenon bulbs and no toxic chemicals.

Due to its five minute cycle time, ease of use, and real-world peer reviewed published outcomes, the Xenex system has proven to integrate smoothly into hospital cleaning operations, providing an additional layer of protection after manual cleaning by deactivating bacteria that might have been missed.

Describe what sets this apart from others available on the market: Xenex is the only UV disinfection solution with published HAI rate reduction outcome studies, including a Lowell General Hospital study showing surgical sight infection (SSI) reductions of >45 percent. www.xenex.com

Contec, Inc.’s PREMIRA Microfiber Wipes and Pads Halyard Health Acute Pain’s ON-Q* Pain Relief System Category: OR Equipment and Accessories Briefly describe the product: The ON-Q* Pain Relief System is a non-narcotic elastomeric pump that automatically and continuously delivers a regulated flow of local anesthetic to a patient’s surgical site or in close proximity to nerves, providing targeted pain relief for up to 120 hours. With the ON-Q* Pain Relief System, patients: • Went home an average of 1.1 days sooner • Reported up to 69 percent lower pain scores • Were up to three times as likely to report high satisfaction scores • Are more likely to experience better pain management with fewer side effects Describe what sets this apart from others available on the market: ON-Q* is indicated to provide better pain relief than narcotics alone and to significantly reduce the need for narcotics. There have been more than 170 studies on ON-Q*. www.halyardhealth.com 42 July/August | 2015 | www.SurgicalProductsMag.com

Category: Infection Control Briefly describe the product: PREMIRA® single-use products offer superior cleaning and eliminate cross-contamination and need for laundering, providing faster OR turnover.

Compatible with the widest range of healthcare disinfectants, including quaternary ammonium compounds, peroxides, and bleaches, the lightweight microfiber wipes, hand pads and floor pads remove fine particles, larger debris and potentially infectious materials from surfaces in critical patient care areas.

Cleanroom-quality and are quat, peroxide, and bleach safe, and reduce HAIs. Describe what sets this apart from others available on the market: The PREMIRA® single-use wipes and pads provide consistent disinfectant dwell time, simplify quality control and eliminate cross-contamination unlike cotton, rayon and laundered mops and rags. www.contecinc.com

ESP Nominees

HoverTech’s Single-Patient Use Split-Leg Category: OR Equipment and Accessories Briefly describe the product: The HoverMatt® Single-Patient Use Split-Leg is a specialty air-assisted transfer mattress designed for use in the lithotomy position or on surgical tables when splitleg plates are employed. When the foot-end snaps of the mattress are fastened, the legs are kept together and lateral transfers can be performed. The legs can then be separated into two individual segments by disconnecting the snaps, and each segment can be positioned with the patient’s legs. This keeps the HoverMatt from getting in the way during procedures. The Single-Patient Use SplitLeg also offers the added convenience of disposability when the patient’s hospital stay is complete.

Describe what sets this apart from others available on the market: The Split-Leg SPU is the only air-assisted lateral transfer device on the market with a split-leg configuration, making it ideal for the OR. www.hovermatt.com

Megadyne’s ZIP Pen Smoke Evacuation Pencil Category: Surgical Instruments Briefly describe the product: ZIP Pen’s unique and innovative design allows surgeons to experience comfortable and precise electrosurgery while minimizing the hazards of inhaling surgical smoke. Unlike other smoke evacuation devices, ZIP Pen offers surgeons three ergonomic options for maximum comfort and functionality. In addition, ZIP Pen is loaded with features, including a clear suction sleeve that encloses the electrode for superior smoke capture without inhibiting visibility, large activation buttons for ease of use, full 360 degree swivel capability and a safety grip for comfort and control. The ZIP Pen’s “one-size-fits-most” connector enables easy connection to smoke evacuators.

Describe what sets this apart from others available on the market: ZIP Pen™ is the only surgical smoke pencil with the ability to remove 100 percent of the torque from the back of the pencil. www.megadyne.com

gSource

®

An instrument of shear genius!

gSource

One instrument provides a clean and easy cutting action for three common rod diameter sizes - 4.5mm, 5.5mm and 6.35mm!

• Rods are sheared, leaving a smooth and clean surface rather than a sharp, jagged, burr-like surface common when using a standard pinching-type rod cutter.

gS 83.7280 22", without

detachable handles, black silicone (shown above)

• Biocompatible silicone handles help to prevent slippage and provide a secure, comfortable grip.

gS 83.7290 22", with detachable handles, black silicone

• Silicone handles have excellent resistance to alkaline, saline and acidic solutions.

gSilicone Rod Shears

• High quality precision instrument made from German stainless steel.

• Full satisfaction guarantee.

800.978.1119 For more information: www.gSource.com

ESP Nominees

Crosstex/SPSmedical’s RAPICIDE OPA/28 High-Level Disinfectant Category: Infection Control Products Briefly describe the product: RAPICIDE® OPA/28 High-Level Disinfectant provides a superior way to reprocess semi-critical medical devices that are unsuitable for sterilization. The industry’s fastest OPA, and one of the longest lasting, now comes specially formulated with a purple tint designed to provide easier identification and differentiation from other clear liquids, as well as lower foaming properties.

RAPICIDE® OPA/28 High-Level Disinfectant features 10 minute manual disinfection time at 20°C, five minute AER disinfection time at 25°C, 28 day reuse life, and guaranteed materials compatibility, offering the ultimate combination of safety, convenience and value.

Describe what sets this apart from others available on the market: RAPICIDE® OPA/28 High-Level Disinfectant features the fastest disinfection time of any OPA on the market and twice the reuse life of 14 day OPAs. www.opa28.com

Tru-D’s Smart UVC Category: Infection Control Briefly describe the product: Tru-D SmartUVC pioneered the UV disinfection space and continues to be the trusted choice for healthcare professionals who share a commitment to infection prevention and patient safety. Our patented Sensor360 technology ensures a measured, lethal UV dose that cleans a room from one position in an operating room. Validated by more than 12 independent studies, Tru-D ensures 99.99 percent pathogen reduction in direct and indirect shadowed areas and eliminates human error in the perioperative disinfection process. The inability to measure reflective dose plagues all other competitors. Real-time usage tracking, iTru-D, optimizes usage and integrates with current performance measurement.

Describe what sets this apart from others available on the market: Tru-D SmartUVC’s measured dosing capabilities ensures 99.99 percent disinfection of an entire room from one position, a claim backed by independent researchers. tru-d.com

The revolutionary absorbable subcuticular new patient-centric standard for skin closure... introducing

just got shorter!

8 Staples

an absorbable subcuticular staple for skin closure Rapid Knotless Port Closure

The INSORB Shorty Stapler is designed to close shorter incisions, including endoscopic ports, resulting in a secure, everted closure

44 July | 2015 | www.SurgicalProductsMag.com

www.insorb.com

Vestagen Technical Textiles’s VESTEX OR Select category: Apparel Briefly describe the product: VESTEX® is the original innovative fabric technology to embed fluid-repellent, antimicrobial and breathable properties in OR attire to better protect patients and staff from dangerous pathogens. The permanently bonded technologies reduce the risk of blood and bodily fluid exposure on behalf of the wearer and are durable enough to withstand 50 industrial washings.

VESTEX is the only fabric proven to be clinically effective at inhibiting growth of bacteria on the fabric. In addition, VESTEX follows new AORN guidelines for surgical attire and has also earned the exclusive endorsement of the American Hospital Association for active barrier technology.

Describe what sets this apart from others available on the market: VESTEX is the first OR apparel to offer fluid-repellent, antimicrobial and breathability.

It remains the only fabric clinically proven to reduce acquisition of harmful contaminants. vestagen.com

Bariatric Surgery

Awareness Lacking for Treatment Patients and some physicians lack education, which means not all candidates are reached

by Rebecca Rudolph, editor

A

ny person could accurately say obesity rates are increasing in the United States. With more than one-third of Americans being labeled as obese by the Centers for Disease Control and Prevention (CDC), that means heart disease, stroke, type 2 diabetes, joint damage and more weight-related issues are on the rise too.

Dieting and exercise might be a solution for some overweight people, but when the American Medical Association recognized obesity as a disease in 2013, it also recognized this condition as more than a common lifestyle issue; it recognized it as an epidemic with patients who need help. While different types of bariatric surgery can help most obese patients get back to a healthy track, there are still gaps in care, said bariatric surgeons Dr. John Morton, president of the American Society for Metabolic and Bariatric Surgery (ASMBS) and chair of the American College of Surgeons (ACS) Committee for Metabolic and Bariatric Surgery, and Dr. Raul Rosenthal, president-elect of ASMBS. Specifically, a lack of education on the benefits of surgery, and patients not acknowledging they need help are why Morton and Rosenthal think only 1 percent of the eligible 18 million patients undergo bariatric surgery.

Rosenthal said most surgeons in other specialties recognize the benefits of bariatric procedures, and when they refer obese patients, it’s because the individual needs to have another surgery, but their weight puts them at high risk. While Morton said there isn’t a specific number of these types of cases, he roughly estimates those account for about 20 percent of bariatric surgery patients.

He adds that the risk associated with any of these procedures is minimal when patients selected accredited centers,

and the mortality rate was about the same as getting a gallbladder removed or a knee replaced.

Unfortunately, primary care physicians are normally the ones who don’t understand the procedure or the options bariatric surgery can provide, Morton and Rosenthal said. Both the public and healthcare workers need to be taught about the spectrum of care for obese patients, which ranges from diet and exercise to surgery. With more education, Rosenthal anticipates patients will most likely be referred sooner before any complications from obesity are realized.

The other gap is in how willing patients are to realize, first of all, that they’re obese, and, second of all, they need help to get healthy again, Morton said. Obese people have a body mass index (BMI) of 30 or more and don’t always see themselves as candidates for surgery, unless a healthcare physician tells them they are, Rosenthal explained.

“Unfortunately, they come too late very often,” he added, meaning their weight had already lead to other medical compilations. “The reason that happens is because of lack of information, not only with the public but with physicians, about obesity being a disease.”

Obesity rates continue to increase for all demographics, including youth. Some patients younger than 18 years old have had bariatric surgery, but most aren’t considered as candidates until they’re adults. Typically, patients are middle-aged women, even though middle-aged men are just as likely to be classified as obese. Rosenthal said this could be attributed to women caring more about their health than men, and therefore seeking out help more often.

Because of the unmet patient needs for both genders, Morton and Rosenthal said it’s important these gaps in care are met with education, so obesity is treated and patients can start to live healthier lives.

Specifically, a lack of education on the benefits of surgery, and patients not acknowledging they need help are why Morton and Rosenthal think only 1 percent of the eligible 18 million patients undergo bariatric surgery.

www.SurgicalProductsMag.com | July/August | 2015 45

PRODUCT SPOTLIGHT: Carts and Storage

Adjustable-Height Prep and Pack Workstation Blickman’s Prep and Pack Workstation sets a new standard by combining ergonomics and modular flexibility to help streamline and optimize your workflow. The Adjustable-Height Prep and Pack Workstation features fullrange, a stainless steel work surface and components, user-configurable modularity and more accessory solutions. www.blickman.com

Blue Bell Medical Wireless Auto Lock Carts Blue Bell Medical carts offer independently accessed drawer lock and auto re-lock for increased security of controlled substances or valuables. Auto Lock carts offer optional proximity or mag-stripe card reader that works with your existing employee identification cards. bluebellbiomedical.com

D-Series Blanket and Fluid Warming Cabinets MAC Medical, Inc.’s D-Series (Data Logging) Blanket and Fluid Warming Cabinets are user friendly, temperature recording devices. The independent, digitally controlled heating chamber offers actual temperature and set point displays. Data is recorded every 30 minutes and stored for up to two years. Plug and play data download requires no additional software. www.macmed.com

Fire-Resistant Cart and Cart Covers EDGECO’s fire-resistant cart features shelves with an open wire construction, enabling a free distribution of air and each shelf can support more than 400 lbs. It’s available in heights up to 78 inches, and has various shelf sizes, which can be adjusted in 1 inch increments.

Fire-resistant, antibacterial cart covers are also available. www.edgecoamerica.com 46 July/August | 2015 | www.SurgicalProductsMag.com

Complete

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With our complete cart & storage solutions, we can help your facility maximize its storage needs by utilizing products such as our Blanket & Fluid Warming Cabinets, Case Carts, Utility Tables, Nurses Documentation Stations, and Supply & Overhead Storage Cabinets.

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Supply & Overhead Storage Cabinets

SIONS 4k Imaging

Image Updates Approached Carefully Readers shared how new resolution and size options impacted purchasing decisions

by Rebecca Rudolph, editor

M

ost respondents to our survey work in hospitals with responsibilities ranging from being a member of the surgical team to facility administrator to materials manager. Their feedback indicates a simultaneous appreciation for the role this equipment plays, and a cautious purchasing approach to acquiring the latest and greatest visualization equipment.

Some key takeaways included: • About 95 percent of respondents indicate monitors and visualization equipment is important or extremely important to their success in the OR, but nearly all surgeons and surgical technicians ranked this as an extremely important.

• 80 percent of all facility administrators and material managers view OR visualization equipment as extremely important, and two-thirds of OR managers and nurses agreed.

Ideas on purchasing priorities: • 56 percent of respondents state that their visualization equipment “is good for now”.

• Just over 31 percent state that their equipment is either brand new or recently purchased.

• More than 12 percent indicate the need for replacements or updates within the next six months.

• Just under half of respondents upgrade visualization equipment at a timeframe of between 12-20 months.

• 56 percent said they are not on a set schedule for upgrades, possibly indicating they update as demanded by new procedures, facility expansions or in adopting new technologies.

• Leading drivers of investment include image quality, surgeon preference and cost.

Technologies currently being employed: • 85 percent report the use of HD imaging equipment.

• 16 percent utilize 3D technology.

• In line with its relatively new availability, just over four percent have 4K equipment.

• Surprisingly, 19 percent report still utilizing non-HD visualization equipment in some way.

Wave Hello to Hybrid OR Gesture Control Black Diamond Video’s Gesture Control delivers comprehensive control of the 8 Megapixel display in the hybrid OR. With the wave of a hand, choose from infinite windowing layouts and perform video routing at any time from the sterile field.

Another industry first and industry best from the technology leader in OR integration.

503 Canal Boulevard, Point Richmond, CA 94804 www.blackdiamondvideo.com 510.439.4500 | info@blackdiamondvideo.com

Superior Video Processing Technology for Mission Critical and Real-Time Display Projects

4k Imaging

New Option Brings More Clarity 4K suppliers describe the tech and what it means for ORs

by Rebecca Rudolph, editor

F

irst, there were high definition (HD) monitors. Then, there were innovations in three-dimensional (3D) imaging, and now 4K monitors are delivering a new level of clarify to the medical community. As per usual, these monitors were released to the consumer market first, which is where Ultra HD was termed to describe the 2160 by 3840p option.

4K monitors, which feature quadruple the resolution of the HD 1920 by 1080p monitors, were released to the surgical market last year, and manufacturers agree they bring new elements of depth and clarity to the table. Evan Krachman, Sony’s product managernew business development, said healthcare professionals have been looking at the monitors they’re about to release and have commented that the improved resolution makes the image look like it’s in 3D, but without the glasses.

Devon Bream, Black Diamond Video’s vice president of global medical sales and marketing, said he’s also seen a positive response to 4K, and added once surgeons use it, they’ll understand the opportunity. “The early adopters will be able to justify the initial higher costs due to the improved work flow and efficiencies gained by viewing greater detailed anatomy, utilizing multiple modalities, and improving patient outcomes,” he explained. “Without question, any facility considering new imaging platforms, and new OR integration to manage the imaging, must consider 4K.” As talk of 8K monitors starts to circulate too, Anne Bondulich, Sony’s marketing manager for surgical products, said the idea is that more clarity will offer more efficiency. “Everyone in the room

has better visualization of what’s going on in the body, so you have your secondary surgeons and your nursing staff that can better anticipate what’s needed next,” she explained.

8K is still down the road, so, for now, 4K offers the highest quality the market has seen, Bream said. He added the more densely formatted pixels offer another bonus – when the screen is broken into modules to show different aspects of the surgery, each quadrant possesses the original HD resolution. This is important when it comes to routing and mapping all the clinical data, in addition to the endoscopic image, he explained.

“Doctors want to see as much detail as possible when performing a surgery or making a diagnosis,” Brian Schlueter, FSN’s senior marketing manager, agreed. “With all else being equal, the highest resolution possible will be the choice for medical professionals. If 4K follows the same price-decline pattern of other video technologies, then it will become more popular.”

Since 4K is the newest release in imaging, it’s the more expensive option on the market, but Michael Foldes, FSN’s East coast general manager, pointed out it has come down in price since the technology was originally released. Schlueter added he thinks it will be relied upon eventually for the intricate and highly detailed surgeries because of the enhanced image.

Imaging Issues

Although there are benefits with any new technology, imaging manufacturers do realize the market is still adjusting.

“The current drawback with 4K is the lack of signal generating devices,” Schlueter said. “HD signals are now commonplace. A 4K monitor needs a 4K signal in order to show its full potential, and 4K signals are not yet common.”

This includes the laparoscopic camera market, Sony specified. While there are converters that work, Krachman shared converting the image from HD laparoscopic cameras into 4k imaging doesn’t always provide that authentic 4k image. There are cameras currently being developed by other manufacturers that will stream in 4k instead of it having to be converted, he said.

Experts say the higher resolution of 4K makes viewing multiple images on one screen clearer. (Courtesy of Black Diamond Video) www.SurgicalProductsMag.com | July/August | 2015 49

PRODUCT SPOTLIGHT: OR Visualization Monitors

27" Radiance Ultra The new 27" Radiance® Ultra surgical visualization platform from NDS Surgical Imaging boasts the brightest LED backlight in its class.* The brightness level overcomes glare in high ambient light environments, allowing surgeons to more easily visualize recessed anatomy. Proprietary Medi-Match™ color calibration technology gives clinicians added confidence that the color of tissue and other anatomy is rendered accurately and consistently. *The highest output luminance at 6500°K color temperature, 900 cd/m2 (typical).

www.ndssi.com

Sony’s 27" 2D HD Monitor M it Surgical Grade Touch Screen The FS-L2701DT 27" display monitor from FSN Medical Technologies features touch screen display, a slim design and a flush-front glass bezel. The screen size is large for manipulation of touch screen elements, yet small enough to mount on a moveable arm or boom if required. www.fsnmed.com

The robust edge-to-edge OptiContrast Panel™ protects the screen while reducing glare and reflection, while the 27" screen provides a larger full HD (1980 x 1080 pixels) viewing area and fits onto the same carts and boom arms that currently take 26-inch models. The monitor is available in two versions; the LMD-2760MD with digital only (DVI and 3GSDI) interface and the LMD2765MD with digital and analog interface (Video, S Video and HD-15 inputs). www.sony.com

INDEX OF ADVERTISERS 3M Infection Prevention. . . . . . . . . . . 3 Access Intelligence . . . . . . . . . . . . . 13 Action Products Inc . . . . . . . . . . . . 34 Allen Medical Systems . . . . . . . . . . . 5 Black Diamond Video . . . . . . . . . . . . 48 Buffalo Filter Co . . . . . . . . . . . . . . . 21 CareFusion . . . . . . . . . . . . . . . . 32, 37 Cincinnati Sub Zero Products . . . . . . 25 CooperSurgical . . . . . . . . . . . . . . . . 17 Enthermics Medical Sys . . . . . . . . . 24

EPS, Inc. . . . . . . . . 27, 29, 31, 33, 35 gSource . . . . . . . . . . . . . . . . . . . . . 43 Healthmark Industries Co . . . . . . . . 39 HoverTech International . . . . . . . . . . 22 I.C. Medical, Inc . . . . . . . . . . . . . . . 15 Incisive Surgical . . . . . . . . . . . . . . . 44 Innovative Medical Products . . . . . . . . 2 Mac Medical . . . . . . . . . . . . . . . . . 47 Megadyne Medical Products, Inc . . . 19 Millennium Surgical Corporation . . . . 38

50 July/August | 2015 | www.SurgicalProductsMag.com

Pacira Pharmaceuticals . . . . . . . . .9-10 Polar Products . . . . . . . . . . . . . . . . 23 Sharn, Inc . . . . . . . . . . . . . . . . . . . 27 Society of Laparoendoscopic Surgeons . . . . . . . . . . . . . . . . . . 51 SPS Medical . . . . . . . . . . . . . . . . . . 31 Stryker Communidations . . . . . . . . . 52 SurgiMark . . . . . . . . . . . . . . . . . . . . 7 Xenex Healthcare Servies . . . . . . . . 41 Zimmer . . . . . . . . . . . . . . . . . . . . . 11

PROFESS Navigation ™

Pattern Recognition Optics for Functional Endoscopic Sinus Surgery Patient Tracking and Registration • Single use registration stickers allow for easy placement Control and Accuracy • Image processing and tracking algorithms compute position and orientation • System accuracy of ±2 mm within the nasal cavities • Patient tracker can be removed and placed back on without losing registration Integrated Lightweight Instrumentation • Pre-calibrated, single use, and light weight instrumentation • Four ergonomic instruments incorporate into the procedure

The first video tracking navigation system for FESS

Scan this QR code to see a PROFESS system demonstration

A physician must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that physicians be trained in the use of any particular product before using it in a procedure. A physician must always refer to the package insert, product label and/or instructions for use before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets.

9100-003-440 Rev. None

For more information visit stryker.com/navigation