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Advancing Essential Surgery Through Instrument Maintenance

  • May 1, 2020
  • Blog
Keith Miles

Keith Miles

Miles has over 14 years’ experience refurbishing surgical instruments for the largest surgical device repair company. He’s a board-certified sterile processing technicians and surgical instrument specialist and has a BA in International Studies from the University of Alabama at Birmingham.

On the coast of Africa, standing on the deck of a Mercy Ship hospital, SSI Founder Willie Miles looked out on the horizon as hundreds of people lined up to received medical care. It was a transformative moment for him. A moment that would be the genesis for the creation of Safe Surgery Initiative. What started off as a two-week mission became a lifelong passion to help the disadvantaged peoples of the world received life-saving surgical care. Safe Surgery Initiative (SSI) is a US-based nonprofit organization that provides on-site surgical instrument refurbishment, capacity building, and education to medical facilities in low-income and middle-income countries.

Now he wasn’t a surgeon, a doctor, or a nurse. He wouldn’t be the one performing life-saving surgery that restored sight, or corrected deformities. But what he could do is make sure the people performing these surgeries had the best surgical tools at their disposal. As a Surgical Instrument Consultant, he manages surgical instruments inventories and refurbished those instruments. He could make sure the instruments cut, bite, grasp, and function to the surgeon’s expectation. Reducing the amount of complications that can arise during surgery.

Proper maintenance of surgical instruments begins in the hospital’s CSSD – Central Sterile Service Department. This department is responsible for decontaminating, reprocessing and sterilizing surgical tools and equipment. Without a working CSSD, it is very difficult to perform safe surgery. SSI’s job therefore begins with inspecting whether the CSSD is functioning as it should. Providing process improvement recommendation when needed. From there, an SSI sends a technician to setup a fully functional repair lab at the hospital. All the equipment used at the lab is brought to the respective hospitals from the US by the technician. The technician repairs the hospital entire surgical instrument inventory over a two-week period.

You are probably wondering what this involves. It basically involves inspecting surgical instruments, reengineering them so they work properly, and refurbishing them so they work better. Sometimes surgical instruments get rusty, misaligned, or damaged. This stops the proper functioning of the surgical tool. All instruments dull over time with use, and parts become worn and need replacing. Without a skilled surgical instrument repair specialist these problems go unfixed.

When surgical equipment doesn’t function to the surgeon’s expectations, it slows down the entire procedure, which impedes the efficiency of the OR. Hence, fewer surgeries are performed in the long term. When surgical instruments are not maintained on a regular basis, the risk to patient safety increases. Broken or malfunctioning surgical tools can cause unnecessary trauma to tissue. Having proper working instruments can improve the success ratio per procedure. It will also limit hand fatigue and OR frustrations caused when instruments don’t cut, bite, or grasp properly while in surgery. SSI’s refurbishment process can extend the life and functionality of surgical instruments, saving money that can be used for patient care.

At the forefront of every repair is patient safety and end user satisfaction. Scissors should cut, not tear. Needle Holders should grip not slip, Rongeurs should bite, not squeeze. That’s how SSI supports the global efforts of surgical mission teams, charities and hospitals working in LMIC’s. These organizations provide surgical care to the disadvantaged peoples of the world. We will continue in that role as we setup new repair labs and training workshops across Asia, Africa and the Americas.