The Operating Theatre Journal

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Tel: 0845 051 4244 Fax: 0845 051 4255 e-mail: [email protected]

September 2010 Issue No. 240 ISSN 1747-728X

Phone: 01204 555999 Fax: 01204 523595 www.vernacare.comV e r n a c a r e L i m i t e d , F o l d s R o a d , B o l t o n , L a n c a s h i r e B L 1 2 T X

The new Vernatray, developed with front line theatre practitioners to provide safer care in thehospital environment. The new single use tray makes it easier for clinicians to locate the relevantsyringe and medication, it is ideal for use by anaesthetists during perioperative care.

In evaluations carried out with Theatre staff, Consultants, Operating DepartmentPractitioners & Anaesthetists:

100% said the syringes were stable in the tray95% said it was easy to correctly identify the labels on the syringes72% find the Vernatray easy to use

Trust me, I’ma safe tray

Foryour freesample call

01204555999

NEW

nd out more 020 7100 2867 • e-mail [email protected] Issue 240 SEPTEMBER 2010 3

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the pages of www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

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Mobile phone hygiene risk to millions of people in the UK

New technology, from smart and mobile phones to laptops, could be spreading illnesses and potentially killer diseases because of poor hand hygiene, according to research released recently (16 August 2010) by The Co-operative Pharmacy.

Each year, more than 750 people die and almost one million people¹ are ill with bugs which can be passed on or contracted by not washing hands.

As part of its ethical strategy, The Co-operative Pharmacy commissioned the study by ICM² into hand hygiene, which revealed that one in three people use a mobile phone or BlackBerry when on the toilet while one in twenty people also surf on a laptop.Almost one in three people admitted to not using soap or handwash and one in ve people don’t always wash their hands after being on the loo.

Mobile and smart phones³ have been shown to be dirty and have high levels of bacteria, which indicate poor personal hygiene, and act as a breeding ground for other bugs.

The research by The Co-operative Pharmacy also found that one in ten people said they never or only sometimes washed their hands while people admitted to reading a newspaper or magazine (48 per cent), cleaning their teeth, drinking and eating when on the toilet.

John Nuttall, Managing Director of The Co-operative Pharmacy, said: As a leading community pharmacy we believe it is vital to make people aware of the importance of good hand hygiene when visiting the toilet.

In the UK, the new trend of using smart and mobile phones in addition to laptops on the toilet is inadvertently raising the risk of the spread of infections, which affect hundreds of thousands of people. The symptoms are very unpleasant for most people and, in some circumstances, can be fatal.

Dr. Paul Cleary, Epidemiologist, Health Protection Agency, said: Hand-washing is important at all times, but particularly after going to the toilet, before and after preparing food and before eating.

Thorough handwashing with soap and water is the best protection against C diff and viral infections, such as the common cold, u and norovirus. It also reduces the chances of cross-contamination when preparing food and therefore affords some protection against food-borne infections, such as salmonella and campylobacter.

As well as championing good hand hygiene among local communities, The Co-operative Pharmacy is also working with UNICEF to boost cleanliness and sanitation standards in the developing world and has pledged £300,000 to support a community project in Togo. It will help to build 6,000 toilets in 300 villages, to improve the health of an estimated 110,000 children and their families.

John Nuttall added: In developing countries, diseases spread by poor hand hygiene and inadequate sanitation are far more common and deadly and cholera, dysentery and diarrhoea kill 4,000 children each day. In Togo diarrhoea causes a third of all deaths among children under the age of ve.

Customers can support UNICEF’s work by making a donation at any branch of The Co-operative Pharmacy nationwide.To nd your nearest branch visit: www.co-operative.coop/pharmacy

1. According to the NHS 850,000 people a year are ill with food poisoning which is also attributed to 500 deaths each year (http://www.nhs.uk/conditions/food-poisoning/Pages/Introduction.aspx). The Health Protection Agency infection outbreak reports that around 52,000 a year are ill with gastrointestinal infections (http://www.hpa.org.uk/hpr/archives/Infections/2010/enteric10.htm) and 40,000 people suffer with C Diff in primary care organisations and hospitals (http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1254510678961) while the National Of ce for Statistics reported 163 C diff related deaths in 2009 (http://www.nisra.gov.uk/demography/default.asp29.htm)

2. The survey questioned 2018 people and found that on the toilet:• 48 per cent of people read a newspaper or magazine • 32 per cent used a mobile phone or Blackberry • 8 per cent cleaned their teeth • 8 per cent drank or ate • 4 per cent surfed on a laptop

When soap and handwash is available, people were surveyed on how often they use it:• 72 per cent said always • 9 per cent said that they sometimes, occasionally or never washed.

Obesity expert raises concerns about allocation of weight loss surgery

Dr David Ashton, medical director of Healthier Weight, the leading provider of obesity surgery and procedures including non surgical balloons, claims that despite rising numbers of procedures on the NHS cited in the British Medical Journal (BMJ) recently, a substantial number of eligible candidates for surgery are missing out.

The British Medical Journal (BMJ) reported weight-loss procedures rose from 238 in 2000 to 2,543 in 2007, while between April 2000 and March 2008 6,953 operations took place. According to Dr Ashton, best estimates suggest that of those eligible for NHS surgery, only 1 in 200 will actually be offered it.

Also, the way surgery is currently allocated, said Ashton is largely based on Body Mass Index (BMI). BMI was developed in the 19th century and is much too crude an instrument to be used as the basis for decisions regarding potentially life-saving surgery in the 21st century. BMI discriminates on the basis of age, gender and especially ethnicity. The latter is of great importance because certain ethnic groups have a greater risk at lower BMIs than Caucasian populations

“Bariatric surgery has increased exponentially in England in recent years,” the report said. “In conjunction with the growing level of obesity, as patients become more aware of surgery as a viable treatment option, demand for surgery among morbidly obese patients increases.”

Private company Healthier Weight based in London, Birmingham and Manchester is recognised as a pioneer of bariatric (obesity) surgery and has exclusive relationships with surgeons who have international reputations in the eld of bariatric surgery. Dr Ashton has written guidelines on physical activity for the World Health Organisation and is contributing editor to the Journal of Physical Activity and Health. His latest publication is on the lack of evidence for preoperative psychological screening of the obese can be found in Obesity Journal.

Professor Franco Favretti, works exclusively for Healthier Weight in the UK and is acknowledged as de ning the surgical protocol for gastric band implantation, in particular the pars accida technique and was the rst to place a gastric band through the belly button using SILS, a single incision technique leaving no visible scars. Franco has also made contributions to other surgical procedures for the treatment of obesity, especially biliopancreatic diversion (BPD/DS) and the Bandinaro.

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

PROFESSIONALISM – THE BEST STARTING POINTThere probably aren’t many people, in this country or abroad, who would disagree that it has been a dif cult year in many ways. Even with a new government and a combined will to nd new or better ways to make an impact on our current dif culties, it is likely that it is going to be a while before we nd ourselves in a position where we can all breathe a sigh of relief.

The level of problems we face will affect all of us and each of us will be required to do more with less, get used to having less resources available to us but still be expected to make a positive impact and provide services of high quality.

That’s a laudable idea, lled with good intentions, but what does it mean in reality? How do we go about having that positive impact? How do we make the most of what we have at our disposal? Although we are all in the same boat the necessary changes cannot be driven by government requirement alone. It is, unsurprisingly, up to each of us as individuals to see how we can effect changes around us in both our personal or work lives.

This new and dif cult world we all nd ourselves in is a great time for us all to examine the way we live and work with each other to see what improvements we could make. We are all aware that trust has become a signi cant issue in public life - perhaps our response should be for all of us to take personal and collective responsibility for our actions and live by ethical codes which drive every aspect of our behaviour, both public and private. There are things we can and should do to help ourselves and, most importantly, each other.

This train of thought led me, some while ago, to identify the components of professionalism and to understand how implementing and living its many attributes can have real value for each of us every day. Professionalism is about everything we are and everything we do and takes us into all areas of our lives, at work, at home and socially. It is a living concept not just an academic argument and it affects all of us, in every sector, at any level, whether we work in frontline services or have strategic responsibility for those services.

Some de nitions of the word ‘professionalism’ are evasive and not particularly helpful. They offer circular arguments and little of what it actually means on a personal level. Unfortunately, it’s not hard to make a list of the things we see around us which are completely unprofessional - trust and morality issues involving politicians, bankers, and sportsmen; role models with feet of clay; lack of customer service from utilities and other organisations we interact with daily. Even the United Nations has come to realise that something is amiss and now lists Professionalism as one of its three core values for employee and volunteer roles at all levels.

So my compilation of the essential qualities for professionalism has now turned into a book (Professionalism: the ABC for Success**). As it was taking shape it became obvious that professionalism’s real importance is in the way that moving from abstract attributes to practical application can and should make a difference to the way we interact with each other at every level. So how does the practical side of professionalism help us deal with the challenges we all face, how can it bring bene ts to an individual’s day to day work and lead to increased success in the workplace?

The list of required professionalism attributes falls into three categories – attitude, behaviour and character – the ABC of the book title. Although they cannot all be listed here, nding ways to make professionalism work for you in the workplace is not dif cult. It can be incremental, implementing small differences each day and then, after a while, nding that you have been an agent for change, not just for yourself but also for those around you.

To make a start, put a ring around today’s date on the calendar and make one fundamental decision – to choose excellence. From today you will not accept second rate, your expectations and your delivery will be about nding ways to do everything better, you will ‘go the extra mile’ and provide quality results every time, always taking responsibility for your actions. You adhere to an ethical standard and a professional code of conduct and exceed the expectations placed on you by your role or position. You will be pro-active and look for potential improvements, you will be a problem solver – don’t be one of those who coast along hoping that nobody will notice that you do the minimum possible or that someone else will come up with the answer to your problems.

An unavoidable truth is that people like to work with people they like so managing relationships is a critical aspect of your professionalism and, unsurprisingly, manners matter.

Thoughtfulness and a smile are incredibly powerful tools and will make people want to work with you. Small gestures also matter in our busy lives. Remember personal details about those you work with, be responsive and return calls and emails promptly even if it is only to say I will have to get back to you soon. Acknowledge a job well done. Offer your support to colleagues.

Your belief in yourself is underpinned by your competence and a commitment to CPD (continuing professional development). You will always present yourself in an appropriate and professional way. Tatty jeans and ip ops will not convey the right message, no matter how accomplished you are. Although a suit may not be the required dress code for your work environment, you should always present yourself in such a way that it is obvious you have made an effort.

Treating others with respect is not just about deferring to their status if appropriate, it is also about arriving on time for a meeting, switching off your mobile phone during meetings or understanding if colleagues are under external pressures. Earn respect for yourself by being known as someone with integrity, who is dependable, honest and trustworthy.

One of the magic ingredients is empathy – although we can’t see what others see when they look at us, we can see the results of our interactions with them. Before each and every interaction try to envisage how it might feel to be on the receiving end and plan your approach and response accordingly. You should also be prepared to amend those interactions if you perceive a negative result and can establish why it happened.

Planning (in the short, medium and long term), managing your time and being well organised are the main tools for being as effective as possible. Start each day with a concise ‘to-do’ list or plan and consult it if intrusions occur. Only you can know if the ‘new’ is important or urgent enough to replace something already on the list.

Managing impressions, managing yourself and your relationships will ensure that you are noticed for all the right reasons and thereby enhance your reputation – and that’s a good place to start!

“If we all did the things we are capable of doing we would literally astound ourselves” – Thomas Edison

** “Professionalism: the ABC for Success” by Susie KayPublished by Professionalism Books at £10.99; ISBN: 978-0-9565401-0-2

Now available from:

• www.professionalismbooks.com• Amazon• All good bookshops

Susie Kay is Founder and Managing Director of The Professionalism Group, an advice and consultancy organisation working with individuals, students, organisations and professional institutes, focusing on the concept and ideals of professionalism (www.theprofessionalismgroup.co.uk and www.theprofessionalismblog.com ). She is an inspirational speaker and writer and is happy to run workshops within your organisation.

Infection Prevention 2010 has launched free exhibition registration.Infection Prevention 2010 - Bournemouth International Centre, 20-22 September 2010

Infection Prevention 2010 Conference and Exhibition is being held at the Bournemouth International Centre from 20th 22nd September 2010. Organised by the Infection Prevention Society this event is the major infection prevention conference and exhibition of the year. The conference has been awarded 16 CPD points and it attracts over 700 delegates and will have a glittering array of speakers covering all your infection prevention needs.

Infection Prevention 2010 features the UKs largest infection prevention exhibition, comprising of 120 companies showcasing new technologies, the latest products along with strategies for implementation. Access to the exhibition only is FREE.

For further information contact 01506 811077 / ips@ twise.co.ukWebsite: www.infectionpreventionconference.org.ukTo book to attend the conference: http://www.infectionpreventionconference.org.uk/booking.php To book to attend the free exhibition: http://www.eventsforce.net/ twise/16


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Swann-Morton launches Cygnetic at AfPP Swann-Morton, Stand 38, Hall C, AfPP (Association for Perioperative Practice) Congress and Exhibition,Harrogate International Centre, 14 – 16 October 2010

Following years of development and recent formal trials at Shef eld Teaching Hospitals, Swann-Morton will launch its Cygnetic blade and handle range at AfPP on stand 38, hall C. The unique design offers a major breakthrough for rigorous orthopaedic procedures and for general surgery, where excess lateral pressure can sometimes be placed on the blade.

The Cygnetic handles lever operated system allows for safe and easy blade attachment and removal. When the blade needs changing or the procedure is completed, the theatre nurse can simply drop the blade into a sharps container or counter box, with no handling of contaminated sharps. Once the procedure has ended the handle can be disassembled by the decontamination and reprocessing centre ready for cleaning.

Cygnetic has been trialled at the Shef eld Teaching Hospitals. Following a demonstration to Gill Cryan, Assistant Manager, Sterile Services,

31 experienced decontamination staff carried out a disassembly and reassembly routine on a Cygnetic handle on average 10 times each over a 24-hour period. Staff commented that the routine was relatively easy, taken within the context of the usual day-to-day tasks faced by the Decontamination Unit.

Cygnetic provides the surgeon with additional strength and stability through a patented combination. The blade is manufactured from a thicker speci cation of stainless steel, which is gripped rmly on both sides once secured within the special handle.

Following the trials Consultant Orthopaedic Surgeon, Mr A J Hamer, commented on the new range of Swann-Morton products: The feel, weight and balance are good. I found removing and detaching the blades straightforward.

Initially the range will include four stainless steel blade shapes, the CYG 10, CYG 11, CYG 15 and CYG 20, available in boxes of 50.

To nd out more about the full range of Swann-Mortons orthopaedic products, which includes the traditional Swann-Major range, and to discuss the bene ts of Cygnetic with senior management and product specialists, visit stand 38, hall C.

For further information on the full range of Swann-Morton products please contact:Chris Taylor, Swann-Morton, Tel: +44 (0)114 234 4231, Email: [email protected] www.swann-morton.com

The Cygnetic handles lever operated system allows for safe and easy blade

attachment and removal.

When responding to articles please quote ‘OTJ’

Anaesthetic agent major contributor to

global warming: Study

Inhaled anaesthetics widely used for surgery-particularly the anaesthetic des urane - are a major contributor to global warming, according to a new study.

Dr. Susan M. Ryan of University of California and computer scientist Claus J. Nielsen of University of Oslo said that sevo urane, iso urane, and des urane are recognized greenhouse gases.

Using des urane for one hour is equivalent to 235 to 470 miles of driving.

The anaesthetics “usually are vented out of the building as medical waste gases and remain in the atmosphere for a long time,” the researchers write.

Ryan and Nielsen suggest some “simple, knowledge-based decisions” that anaesthesiologists can follow to minimize their environmental impact unless there are medical reasons to use it and avoiding unnecessarily high anaesthetic ow rates, especially with des urane.

The study was published in the July issue of Anaesthesia & Analgesia. (ANI)

Source:Thaindian News


NHS Working Hard To Manage Severe And Complex ObesityExpert obesity group welcomes news that the NHS is working to address the nation’s growing number of people suffering with severe and complex obesity.

New gures highlighting an increase in weight loss surgery published in the latest issue British Medical Journal is good news for those suffering from the associated health concerns of severe and complex obesity, and good news for the NHS who will reap the rewards of their investment in this life-saving and cost effective treatment.

When faced with such an epidemic, healthcare professionals have little choice but to respond. The 1992 Health of the Nation report set targets for weight reduction in the English population by 2005, but obesity rates have continued to climb.

There are currently over one million people in the UK suffering with severe and complex obesity (de ned by NICE as a BMI of over 40 or between 35 and 40 if suffering from other signi cant disease). The focus in the health care system has previously been on prevention and on tackling obesity through advocating a healthy lifestyle and the efforts in this eld need to be maintained. However, for this group of people already suffering from the co-morbidities associated with Severe and Complex Obesity, which is a regulatory disease and no longer a behavioural issue,8 evidence shows that this approach is insuf cient and probably scienti cally and professionally inappropriate.

There is mounting evidence3,4 suggesting that bariatric surgery not only has the capacity to induce major weight loss in the long term, but patients having undergone surgery are also are less likely to die from heart disease, diabetes and cancer, compared to severely obese patients who do not. In particular, studies show that people seeking no treatment for their severe obesity have a 40% higher mortality rate over seven years than those who underwent bariatric surgery.

We now know that bariatric surgery can ‘cure’ diabetes in 84% of cases, sometimes within days, resulting in patients no longer needing costly treatments with drugs such as insulin. 9 Sleep apnoea syndrome - thought to account for 300 deaths on the road each year where patients fall asleep at the wheel - enters remission10, and over a seven year period, cancer death rate is halved in patients who have had surgery compared to those who did not.9 Where as non-surgical treatments have not been demonstrated to result the levels of lasting weight loss required to affect these associated conditions.10

Contrary to some opinion, bariatric surgery does take in to account an overweight person’s overall well being. Treatment with bariatric surgery is not only about the surgery itself, but about the commitment of the patient to attend pre and post operative care meetings with a team of multi-disciplinary healthcare professionals comprising a surgeon experienced in bariatric surgery, psychologists, endocrinologists and dietitians, which is utilised and crucial for guaranteeing the long term success of the procedure. The involvement of a truly multi-disciplinary team of accredited health care professionals working within a clinical setting ensures high standards of clinical governance for the care provided.

Cost is often cited as a major barrier to NHS managers and other interested parties. The management of this obesity epidemic is currently costing the NHS around £4.2 billion, with indirect healthcare and societal costs estimated at around £16 billion; gures which have been predicted to more than double by 2050.2

However, surgery is cost-effective, with gastric bypass paying for itself within 3.5 years due to reduced drug costs and hospital admissions, this before taking into account the individual’s renewed productivity, and bene t - rather than burden - to the economy.

Bariatric surgery is the only long term proven solution to weight loss. A change in lifestyle is of course essential, but for those that suffer from severe and complex obesity and who have tried to lose weight through diet, exercise and pharmaceutical treatment with no success, bariatric surgery is often their last option to lose weight and live a healthier lifestyle. Unlike many commercial slimming programmes for which there is often little or no evidence beyond short-term anecdotes, evidence for the safety and bene t of bariatric surgery comes from high level studies including randomised controlled trials, case-controlled studies and formal audit against national guidelines and that has been openly published in peer-reviewed journals.

Professor Nick Finer, Consultant Endocrinologist and Chairman of ESCO, the independent multi-disciplinary group made up of experts in obesity management, comments; “Weight loss surgery is not as many people believe an ‘easy option’ or ‘quick x’ for patients. In some ways the surgery makes patients’ lives much harder

than before as they have to make lifestyle changes that require many adjustments and a great deal of support. In treating the associated chronic illnesses, weight loss surgery helps to make people healthier and more functional, while dramatically reducing the need for and cost of healthcare provision.”

References

1 NICE implementation uptake report: [Obesity guidance on the prevention, identi cation, assessment and management of overweight and obesity and in adults and children’ NICE clinical guideline 43 December 2006]

2 Cost - ef cacy of Surgically Induced Weight Loss for the Management of Type 2 Diabetes

3 Buchwald et al. Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis, The American Journal of Medicine. (3). 2009.

4 National Institute of Health and Clinical Excellence (NICE) guidelines, 2006

5 National Institute for Health and Clinical Excellence. Assessment report on the clinical and cost effectiveness of surgery for people with severe obesity. 2002.

http://www.nice.org.uk/guidance/index.jsp?action=download&o=32422&textonly=true

6 Bockelbrink A, Stöber Y, Roll S, et al. Evaluation of medical and health economic effectiveness of bariatric surgery (obesity surgery) versus conservative strategies in adult patients with severe obesity. 2008. gripsdb.dimdi.de/de/hta/hta_berichte/hta203_bericht_de.pdf

7 NHS Statistics on Obesity, Physical Activity and Diet: England, the Information Centre. January, 2008.

8 Counterweight Project Team: A new evidence-based model for weight management in primary care: The Counterweight Programme. J. Hum. Nutr. Dietet. (17). 2004.

9 New England Journal of Medicine: 357;8. August 2007. Long-Term Mortality after Gastric Bypass Surgery. Ted D.Adams et al.

10 http://www.britishsnoring.co.uk/hgv_drivers_and_sleep_apnoea.php

A £3 million project to build two new operating theatres at Wolverhampton’s New Cross Hospital has taken a step closer to reality after plans were submitted for the work to go ahead.Plans were announced after gures revealed that non-emergency operations there are expected to rise by nearly 4,000 over six years.Health chiefs want to create a two-storey extension to house the new operating theatres, and a separate single-storey extension for a recovery ward.

By 2015-16 the number of non-elective surgeries is expected to be 63,555as Wolverhampton City Primary Care Trust boosts the number of city GPs, and does a deal with the Great Midlands Cancer Network.Five options for increasing theatre capacity were presented to The Royal Wolverhampton NHS Hospitals Trust last month, including extending operating sessions from two to three per day.

The new theatres were chosen because bosses said it would see patients operated on at inconvenient times.

A report to Wolverhampton City Council planning committee says two theatres, two anaesthetic units, two preparation areas, utility rooms, scrub rooms and trolley parking zones would be created in the two-storey development.Five beds and a staff base would be in the recovery ward.

The site of the development is currently a service recovery ward. Plans are part of a £100m transformation which includes two multi-storey car parks and a Metro stop.

An emergency admissions unit, which is used by people who have been admitted to the hospital by their GPs or arrive at the hospital themselves as emergency cases, has already been created.

Source: Express & Star

£3m operating theatre project for New Cross Hospital


TIVA STUDY DAYIn conjunction with CareFusion and Covidien, Mediplus is organising a Study Day at the Bristol Medical Simulation Centre (Bristol Royal In rmary) on Wednesday 13th October.

All Anaesthetists are welcome to listen to leading practitioners who will speak about TIVA, its history, application and bene ts, and take part in an interactive workshop on TIVA/TCI pumps and sets as well as a course on the bene ts of BISTM. The response so far has been excellent and due to limited availability we urge interested clinicians to book now to avoid disappointment.

For more information contact Mediplus at the address below.

Mediplus Ltd, Unit 7, The Gateway Centre.Coronation Road, High Wycombe,Bucks HP12 3SU Tel: +44 (0)1494 551200 Fax: +44 (0)1494 536333 Email: [email protected]

New bed push – smoother for patients while making life easier for hospital staff

It has been well documented that manual handling accidents account for 40 per cent of all sickness absence in the NHS, resulting in a cost somewhere in the

region of £400 million each year.

New laws concerning physical effort have been introduced to help combat the problem – and as always, Anetic Aid has also come

up with a product to help solve it.

The Easy Rider® powered bed push gives patients a smoother experience when heading to and from surgery – particularly up or down sloping corridors.

Compatible with almost any make of bed or trolley, it takes away the need for any member of staff to push, as motion - both speed and direction - is controlled by a detachable handheld wireless control unit.

The compact design has a pulling capacity of 400kg – and built-in safety features such as automatic braking and emergency stop. The quiet and smooth variable driving speed also offers gradient control – particularly useful on sloping corridors.

Anetic Aid can be contacted on Tel: 01943 878647 or at,[email protected] When responding please quote ‘OTJ’


Infections following interventional cardiology procedures are very low but if patients are affected, complications can be very serious. Not only do patients suffer through prolonged treatment and longer hospital stays, but the cost to hospitals is also considerable. At the General Hospital of Ioannina in Greece Dr Dimitrios Nikas, MD, PhD, has pioneered the use of InteguSeal* microbial sealant to ensure the risk of infection in his unit is minimized.

With a baseline infection rate estimated to be just 0.2 to 0.3% in percutaneous coronary interventions (1), additional procedures over and above the standard processes for the sterilisation of puncture sites are not always considered necessary. However when a patient started to have fever two days after a percutaneous intervention, the resulting implications for the patient and the hospital caused a radical review of the puncture site preparation.

When doctors examined the patient further they found that he had an Osler node on the big toe and septic emboli on the sole of his foot. Further investigation with CT-angiography showed that the patient had three mycotic aneurysms located on the common iliac, external iliac and common femoral artery. They were the source of the emboli.

The patient was suffering from severe complications triggered by an infection following his percutaneous coronary intervention. He stayed in hospital for approximately six months, had two further serious surgical interventions and was treated with the latest high tech antibiotics which, themselves resulted in a series of secondary complications. The cost to the hospital was estimated at 200,000 Euros.

“This is thankfully a rare but nevertheless serious event,” explained Dr Dimitrios Nikas, Consultant Interventional Cardiologist in the Department of Cardiology. “It made us look for methods to optimize our puncture site sterilization.”

Researching the issue, Dr Nikas, who performs around 300 percutaneous procedures every year, found the article by Tow gh el al (2) detailing a reduction in incidence of wound contamination by skin ora and the ndings of Private Docent Dr Pascal Dohmen (3) which showed a fall in the rate of surgical site infections in cardiothoracic surgery at the Charité Hospital in Berlin, Germany. Both studies had evaluated InteguSeal* microbial sealant.

InteguSeal* is a product of Kimberly-Clark Healthcare and is a single-use, sterile, cyanoacrylate-based lm-forming liquid that binds to the proteins and water in the skin to form a microbial barrier designed to prevent intraoperative contamination of surgical incisions from skin ora while allowing normal transpiration of water vapor. Provided in a ready-to-use applicator, InteguSeal* is intended to be applied on the skin over commonly used surgical skin preparation products prior to a surgical incision. Upon polymerization InteguSeal bonds to the skin and immobilizes the bacteria which survive the application of antimicrobial surgical skin preparation products.

Dr Nikas performs both cardiac and peripheral percutaneous interventions, including carotid, renal and coronary interventions . For the coronary interventions he prefers the radial access whilst for the peripheral interventions he mainly uses a femoral access. Dr Nikas said: “We looked at early skin contamination (after disinfection), late skin contamination, acute bacteremia, late bacteremia and we cultured the tip of the introducer sheaths that remained in the groin for more than six hours.

“One of the things that struck us was the fact that the after skin preparation, 4.8% of patients still had skin contamination with Staphylococus Aureus and in that same group 50% of the sheaths that remained in the groin for six hours or more were positive for Staphylococus Aureus.

“Our study allowed us to conclude that the use of InteguSeal* reduces signi cantly the rates of late skin contamination.”

As a result, procedures have changed in the Department of Cardiology. “We used to leave the introducer sheath in after dif cult, usually coronary, procedures,” explained Dr Nikas. “For example where the patient lost a side branch during the procedure or when the patient had chest pain after the procedure, in other words, unstable patients. This allows us to have quick access in case of urgent repeat catheterization. Now, we stopped leaving introducer sheaths. They are removed at the end of the procedure and we use InteguSeal* for every single interventional procedure.”

Dr Nikas believes that infection prevention will become more of a focus now that interventional cardiology procedures are becoming more and more invasive with more foreign materials implanted into the patient ranging from wound closure devices to percutaneous valves and aortic endografts. He believes that the use of InteguSeal* is justi ed, when using catheters with long introducer sheaths, central venous lines, port access catheters, pacemakers, dialysis catheters and other invasive procedures, as it will minimize the risk of serious infectious complications.

Dr Dimitrios Nikas presented his ndings in Europe in an abstract entitled “Effectiveness of new microbial sealant in reducing bacteremia along with puncture site and sheath contamination after percutaneous interventions” at EuroPCR 2010 in Paris in May 2010 and the MEET Congress in Marseille in June 2010.

References:

1. Staphylococcus aureus infection complicating percutaneous coronary interventions; van Werkum JW, ten Berg JM, Thijs Plokker HW, Kelder JC, Suttorp MJ, Rensing BJ, Tersmette M.; Int J Cardiol. 2008 Aug 18;128(2):201-6. Epub 2007 Jul 30

2. Signi cant Reduction in Incidence of Wound Contamination by Skin Flora Through Use of Microbial Sealant. Shirin Tow gh; William G. Cheadle; Stephen F. Lowry; Mark A. Malangoni; Samuel E. Wilson Arch Surg. 2008;143(9):885-891

3. Reduction in surgical site infection inpatients with microbial sealant prior to coronary artery bypass graft surgery and graft surgery – a case-control study. P.M. Dohmen, D. Gabbieri, A, Weymann, J. Linneweber, W. Konertz. Journal of Hospital Infection, February 2009.

For further information:http://www.kchealthcare.com

REDUCING INFECTION IN INTERVENTIONAL CARDIOLOGY PROCEDURES WITH INTEGUSEAL* MICROBIAL SEALANT

Dr Dimitrios Nikas, Consultant Interventional Cardiologist

InteguSeal*

When responding to articles please quote ‘OTJ’

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OPERATING

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For more information call: 01244 660 954

www.melydmedical.com www.allenmedical.com

© 2010 Allen Medical Systems, Inc. All Rights Reserved

Finger and Arm Traps For Wrist & Shoulder Arthroscopy

D-770566-A1 July 26, 2010Allen Equalizer

Allen Sterile Mesh Finger Trap Disposables

Allen Sizing Kit

Allen Arm Trap Disposables

New functions for Rigel vital signs simulator extend

capabilitiesRigel Medical has upgraded its hand held combination vital sign simulator UNI-SIM http://www.rigelmedical.com/unisim, adding further functions to improve the scope of tests the instrument is able to perform.

The UNI-SIM was the rst hand held simulator capable of undertaking six synchronised vital signs parameter tests simultaneously: NIBP, SpO2, ECG, temperature, IBP and respiration functionality tests.

It has been boosted with the addition of full 12-lead arrhythmias, ST elevation and depression settings and Atrial and Ventricular Pacer simulations. It also bene ts from enhanced precision NIBP simulations, static pressure test settings and wider availability of compatible monitor types and simulation modes (O-curves).

The upgraded UNI-SIM will also continue to provide increasing compatibility with other SpO2 technologies such as Philips.

The simulator comes in a high quality, multi-functional sling-style carry case and can be integrated with the Rigel 288 hand-held electrical safety analyser, printer and barcode solution and pc-software package.

This additional capability and improved portability makes it easier for biomed service engineers to transport the instruments from job-to-job and con gure test solutions by combining all vital signs with electrical safety testing at the same time.

The UNI-SIM and 288 is part of a comprehensive range of high performance specialist biomedical test equipment which can be customised to meet individual requirement. A selection of test equipment solutions and packages are also available upon request.

Rigel Medical is part of the Seaward Group, which is based at Bracken Hill, South West Industrial Estate, Peterlee, Co Durham SR8 2SW. For more information, including pricing, contact our team at: [email protected] or call +44 191 5878730. Please quote ‘OTJ’

Careline® CareSleeve from ConvaTec supports the urine leg drainage bag down

the entire length of the sleeveConvaTec is a global company committed to serving healthcare professionals, hospitals and patients worldwide. In the ConvaTec Continence and Critical Care division they specialise in the development, manufacturing and distribution of single-use devices to hospitals and healthcare sectors around the world.

CareSleeve is a new leg bag support sleeve offering users more reassurance and con dence that the whole bag is kept securely in place. It is part of the Careline® range of urine drainage bags, catheters and accessories designed with patient comfort and safety in mind.

Patients can enjoy some key advantages of CareSleeve, including: • There is no need for straps as the tension required to hold the urine

bag in place is distributed evenly all round the leg. • This construction reduces the risk of constriction or pressure sores

arising.• By retaining the bag in the care sleeve, sounds of liquid movement

can be masked.• The CareSleeve is easy to apply to the calf. • It supports bags of up to 750ml capacity.• It is latex free and made from a soft, comfortable woven material. • CareSleeve is presented in four sizes to incorporate leg

circumferences from 30-90cm (12-35.5”).

Further information on the CareSleeve or Careline® continence management range, may be obtained by telephoning the ConvaTec Continence and Critical Care division on 01527-583600 or email [email protected]: Realise the possibilities™ When responding please quote ‘OTJ’


Eschmann showcase exclusive new accessory range.

Eschmann is proud to present an exclusive new range of operating table accessories designed by Reison Medical, one of Europe’s leading operating table equipment manufacturers.

Now available for purchase within the latest Eschmann operating table accessory brochure, the exclusive new range was developed with the cooperation of surgical clinicians and operating theatre professionals and has been designed to consistently exceed the exacting demands required in today’s modern operating theatre environment.

Shoulder positioner offers superior surgical accessThe Eschmann Shoulder Positioner System integrates seamlessly with Eschmann T20 and T30 operating tables. Fully adjustable the system is suitable for patients of all sizes with removable back supports and shoulder rests to facilitate all procedures involving the shoulder girdle and upper arm.

The Eschmann Shoulder Positioner utilises the powered functions of the operating table to safely position the patient, minimising manual handling. The multi-point fully adjustable head support and fully detachable shoulder rests ensures comfortable, secure patient positioning and unrivalled surgical access to facilitate ef cient and effective surgery.

In addition to shoulder surgery, the Eschmann Positioner can also be used for a variety of other procedures including Elbow arthroscopy, hand and arm surgery and general upper extremity procedures, making this new system truly unrivaled for its surgical adaptability.

Eschmann are leaders in the design and manufacture of superior medical products, including powered operating tables, table accessories and specialist operating tables, to nd out more about our the full range of operating table accessories, call Eschmann todayon Tel: 01903 875747 or visit: www.eschmann.co.uk/accessories

Every accessory is exceptionally easy to use and offers clinicians a host of high performance features and user-friendly, intuitive movement - helping minimise the complexity of patient positioning whilst achieving unrivalled access for surgery.

The comprehensive range includes an easy to use solution for almost every type of procedure with unique features like the simple secure clamp locking mechanism and the intuitive one handed operation of the ball joint armboard, ensuring exceptional comfort and support.

To nd out more on our new range of accessories or, to request your free copy of the operating table accessory brochure call Eschmann today on 01903 875 747 or visit www.eschmann.co.uk/accessories When responding to articles please quote ‘OTJ’

Please quote ‘OTJ’

New research hopes to increase the number of kidneys available to donorsGood news for 7000 patients currently on waiting list for a kidney transplant

Donor kidneys from individuals who have recently died from cardiac arrest perform just as well in recipients as kidneys from traditional ‘brain-dead’ donors, scientists have found.

The University of Cambridge researchers hope their ndings, published today in the journal The Lancet, will increase the use of kidneys from cardiac-death donors (kidneys which were previously viewed by some as inferior) and possibly reform how these kidneys are allocated - thereby increasing the fairness of kidney distribution as well as the likelihood of a successful transplant.

There are currently over 7000 patients waiting for a kidney transplant. Unfortunately, because of the dire lack of donation organs, almost 10 per cent of these patients die every year while waiting for a healthy kidney.

Since the 1970s, the majority of recovered organs for transplantations were from ‘brain-dead’ donors, patients who had suffered massive, irreversible brain injuries and needed arti cial life support to stay alive. However, over the last decade there has been a reduction of these types of donors as a result of better care of patients with acute head injuries and fewer deaths from traf c accidents.

Because of the shortfall of organs, doctors have begun to use kidneys from cardiac-death donors – individuals who have suffered devastating and irreversible injuries and who have then suffered from a ‘controlled’ cardiac arrest (when medical support is gradually removed and the heart stops beating as a result of the injuries sustained). As these types of deaths are much more prevalent, donor organs from these patients are much more readily available.

Unfortunately, although the number of these types of transplants has increased dramatically - since 2000 they have risen from 3 to 32 per cent - there is still reluctance to adopt the use of these kidneys by some transplant specialists because of concerns about the quality of the organs. This new research, however, addresses these concerns, nding that kidneys from cardiac-death donors are of similar quality to those from brain-dead donors.

The scientists examined data from 9134 kidneys transplants which were conducted in 23 centres; 8289 of the kidneys were donated after brain death and 845 after controlled cardiac death. They found no difference in survival rates or kidney function of recipients for up to ve years after transplantation. (The researchers did not have the data to explore the success rates beyond ve years but indicate that there is no reason to suspect longer-term transplant outcomes would be different.) The scientists did nd that some factors decreased the success rate of cardiac-death transplantations: increasing age of donor and recipient, repeat transplantation, and organs kept cold but without blood supply for longer than 12 hours.

Lead author of the paper, Professor Andrew Bradley of the Department of Surgery at the University of Cambridge, said: “Cardiac-death donors represent an extremely important and overlooked source of high-quality donor kidneys and have the potential to increase markedly the number of kidney transplants performed in the UK.”

Currently, kidneys donated by ‘brain-dead’ donors are allocated according to a national points-based system, ensuring equal access to donor kidneys irrespective of geographical location of those on the waiting list. Because of the absence of adequate information regarding kidneys from cardiac-death donors, however, they are instead allocated locally according to the policy of individual transplant centres, an arguably less effective way of distribution as it unlikely to secure the best candidate for receiving the kidney.

Dr Dominic Summers, one of the authors of the paper, added: “What we have shown, for the rst time, is that cardiac-death donor kidneys last as long and work as well as brain-death donor kidneys, and should be regarded as comparable. In view of our ndings, we recommend that cardiac-death kidneys be allocated in a similar way as brain-death kidneys, ensuring better tissue matches and favouring those who have waited longest.

“Cardiac-death donor kidneys currently make up only a third of deceased donor kidney transplants, but hopefully this paper will provide the evidence and impetus to greatly expand the national programme, and improve the national organ donation rates.”

395 Claremont AvenueMontclair, NJ 07042

INTRODUCINGThe Sensible, Safe andComfortable Surgical GownSolution from Origami

“It’s amazing how such a small change to a garment can make a world of difference for our patients,our doctors and our staff!”

—JUDITH BOEHM,RN, ADMINISTRATORPARAMUS SURGERY CENTER,PARAMUS,NJ

Velcro tabs on bothshoulders provide safe and immediate patient

access if necessary.

Who should stock these gowns:

Ambulatory Surgery Centers •

Plastic Surgery Centers •

Breast and Mammography Centers •

Endoscopy Centers •

Your purchase supports cancer research.A portion of Origami profits supports the Susan G. Komen Foundation.See www.orgiamisurgicalgowns.com for details

Top TieWhat used to be in the center back is now at the base of the neck, and this sensible locationmakes the tie as easy to knot as tying a shoe!

Velcro Front Closure Here's where the staff will appreciate the immediacy of access to the patient's front sidewithout rotation or other movements that caninterrupt and/or endanger the patient whenfast chest access is crucial.

The Side TieYour patients will love the simplicity of thisdressing gown, and staff will appreciate it too.It's stressful enough for patients prepping forcare.This simple tie makes comfort that muchsmoother, immediately.

395 Claremont AvenueMontclair, NJ 07042973-619-2395www.origamisurgicalgowns.comTo order or for more information call Frank Sauchelli at 973-639-2395, or email [email protected]. Downloadable order forms are available atwww.origamisurgicalgowns.com

Developed by an anesthesiologist, Origami Surgical Gowns enhance patient

modesty while giving surgeons and medical staff easy patient access when in the

operating room. Velcro tabs open for better patient access during surgery. Easy to

tie side closures simplify the patient’s dressing experience. Made in the USA and

available in two sizes in both a solid or print, Origami products are a durable

quality blend of cotton and polyester, are easy to wear and remove, and have

reinforced ends on all ties for easy to find tie cords. Patients will love the

simplicity. Doctors and nurses will wonder what took us so long to develop them!

IT’S AN OPEN AND SHUT CASE: The Smartest Surgical Gown in the Industry for Patients, Doctors and Staff is an Origami.



“It’s amazing how such a small change to a garment can make a world of differencefor our patients,our doctorsand our staff!”


Velcro tabs on bothshoulders provide safeand immediate patient








Velcro Front Closure Here's where the staff will appreciate theimmediacy of access to the patient's front side

itwitwitwitwitwitwitwitthhouhouhouhouhouhouhououtt rt rt rt rt rt rt rt totaotaotaotaotaotaotaotatitiotiotiotiotiotiotiot on on on on on on on oor or or or or or or ooththethethethethethethet er mr mr mr mr mr mr moveoveoveoveoveoveoveo emenmenmenmenmenmenmene ttststststststs ts ththathathathathathathat att ct ct ct ct ct ct ct canananananananaiinterrupt and/d/or e dndanger hthe pa itient hwhen

395 Claremont AvenueM t l i NJ 07042










































Dr Dominic Summers, one of the authors of the paper, added: “What we have shown, for the rst time, is that cardiac-death donor kidneys last as long and work as well as brain-death donor kidneys, and should be regarded as comparable. In view of our ndings, we recommend

required in today’s modern operatingtheatre environment.

Shoulder positioner offers superior surgical accessThe Eschmann Shoulder Positioner System integrates seamlessly withEschmann T20 and T30 operating tables. Fully adjustable the systemis suitable for patients of all sizes with removable back supports andshoulder rests to facilitate all procedures involving the shoulder girdleand upper arm.

The Eschmann Shoulder Positioner utilises the powered functionsof the operating table to safely position the patient, minimisingmanual handling. The multi-point fully adjustable head support andfully detachable shoulder rests ensures comfortable, secure patientpositioning and unrivalled surgical access to facilitate ef cient andeffective surgery.

In addition to shoulder surgery, the Eschmann Positioner can also beused for a variety of other procedures including Elbowarthroscopy, hand and arm surgery and general upper extremity procedures, making this new system trulyunrivaled for its surgical adaptability.

Eschmann are leaders in the design and manufactureof superior medical products, including powered operating tables, table accessories and specialist operating tables, to nd out more about our the full range of operating table accessories, call Eschmann todayon Tel: 01903 875747 or visit: www.eschmann.co.uk/accessories

Every accessory is exceptionally easy to use and offers clinicians a hostof high performance features and user-friendly, intuitive movement -helping minimise the complexity of patient positioning whilst achieving unrivalled access for surgery.

The comprehensive range includes an easy to use solution for almostevery type of procedure with unique features like the simple secureclamp locking mechanism and the intuitive one handed operation of theball joint armboard, ensuring exceptional comfort and support.

To nd out more on our new range of accessories or, to request yourfree copy of the operating table accessory brochure call Eschmanntoday on 01903 875 747 or visit www.eschmann.co.uk/accessories When responding to articles please quote ‘OTJ’





























“It’s amazing how such a small change to a garment can make a world of differencefor our patients,our doctorsand our staff!”


Velcro tabs on bothshoulders provide safeand immediate patient








Velcro Front Closure Here's where the staff will appreciate theimmediacy of access to the patient's front side

itwitwitwitwitwitwitwitthhouhouhouhouhouhouhououtt rt rt rt rt rt rt rt totaotaotaotaotaotaotaotatitiotiotiotiotiotiotiot on on on on on on on oor or or or or or or ooththethethethethethethet er mr mr mr mr mr mr moveoveoveoveoveoveoveo emenmenmenmenmenmenmene ttststststststs ts ththathathathathathathat att ct ct ct ct ct ct ct canananananananaiinterrupt and/d/or e dndanger hthe pa itient hwhen

395 Claremont AvenueM t l i NJ 07042










































Dr Dominic Summers, one of the authors of the paper, added: “What we have shown, for the rst time, is that cardiac-death donor kidneys last as long and work as well as brain-death donor kidneys, and should be regarded as comparable. In view of our ndings, we recommend

required in today’s modern operatingtheatre environment.

Shoulder positioner offers superior surgical accessThe Eschmann Shoulder Positioner System integrates seamlessly withEschmann T20 and T30 operating tables. Fully adjustable the systemis suitable for patients of all sizes with removable back supports andshoulder rests to facilitate all procedures involving the shoulder girdleand upper arm.

The Eschmann Shoulder Positioner utilises the powered functionsof the operating table to safely position the patient, minimisingmanual handling. The multi-point fully adjustable head support andfully detachable shoulder rests ensures comfortable, secure patientpositioning and unrivalled surgical access to facilitate ef cient andeffective surgery.

In addition to shoulder surgery, the Eschmann Positioner can also beused for a variety of other procedures including Elbowarthroscopy, hand and arm surgery and general upper extremity procedures, making this new system trulyunrivaled for its surgical adaptability.

Eschmann are leaders in the design and manufactureof superior medical products, including powered operating tables, table accessories and specialist operating tables, to nd out more about our the full range of operating table accessories, call Eschmann todayon Tel: 01903 875747 or visit: www.eschmann.co.uk/accessories

Every accessory is exceptionally easy to use and offers clinicians a hostof high performance features and user-friendly, intuitive movement -helping minimise the complexity of patient positioning whilst achieving unrivalled access for surgery.

The comprehensive range includes an easy to use solution for almostevery type of procedure with unique features like the simple secureclamp locking mechanism and the intuitive one handed operation of theball joint armboard, ensuring exceptional comfort and support.

To nd out more on our new range of accessories or, to request yourfree copy of the operating table accessory brochure call Eschmanntoday on 01903 875 747 or visit www.eschmann.co.uk/accessories When responding to articles please quote ‘OTJ’


Enjoy Complete Confidence




























DARTFORD HOSPITAL TRIALS REVOLUTIONARY NEW SYSTEM

The Darent Valley Hospital in Dartford has been chosen as the rst Kent hospital to trial a revolutionary new urology system that will improve patients’ safety and comfort.

The Urology team is using the Mediplus suprapubic catheter system that will mean patients no longer need to undergo a general anaesthetic and the associated risks since it can be tted using just a local anaesthetic during day surgery.

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Dycem contamination control solutions reduce the carbon footprint of

cleanrooms Dycem, world leaders in providing high performance contamination control zones for critical environments show how they are reducing the carbon footprint for users of their products.

Pressure to reduce energy usage and carbon footprints together with eliminating waste are now targets for many organizations and Dycem is no exception. Dycem contamination control surfaces are designed to be fully reusable and have a life expectancy of between three and ve years. They combine a unique polymeric compound and advanced processing technology to create a smooth, washable surface that can be cleaned with a damp mop and squeegeed dry, leaving the oor covering immediately ready for further use, without loss of performance in the capacity to trap contaminants. The alternative products to Dycem contamination control surfaces are peel-off mats. These mats are layered, adhesive coated, polyethylene sheets that are ripped up when dirty and then disposed of as consumer waste.

In a paper by Gerry Prout of Kennet Bioservices, comparison of the use over a two year period of Dycem ooring and peel-off mats is reported. Dycem ooring uses 18 tonnes less of raw materials, saves over 3 million MJ of energy in manufacture and use while reducing emission of greenhouse gases by over 120 tonnes. A single peel-off mat can produce a ball of waste 20cm (8) in diameter that is disposed of directly to land ll sites. Deborah Hoffet, QA manager and microbiologist at the Rogosin Institutes Xenia Division in Ohio, USA, swapped the traditional disposable peel-off mats for Dycem ooring as part of a larger green initiative and now nds that Dycem ooring has proven to be substantially more effective at retaining the particulates, and it can be washed and lasts as long as ve years.

Both suppliers and end users now have a responsibility to consider green initiatives and environmentally friendly options. Dycem High Performance Contamination Control Zones use less raw materials in manufacture, use less energy in production and have a lower carbon footprint than peel-off tacky mats. As Dycem managing director, Mark Dalziel, says it is vital for manufacturers of disposable products to pay attention to the environment and at Dycem, our design team has this in their briefs for new and improved solutions for our users. At the end of their working life Dycem ooring and mats are 85% recyclable and do not contribute to land ll waste.

To learn more about Dycem, their products and solutions for cleanroom users, visit the Dycem website (www.dycem.com) and learn more of users successes with Dycem products or please contact Dycem direct: Dycem Limited, Ashley Trading Estate, Bristol, BS2 9BB T +44 (0) 117 955 9921F +44 (0) 117 954 1194 Email: [email protected] When responding please quote ‘OTJ’

The hospital, which serves the people of Dartford, Gravesham, Swanley, Bexley and neighbouring districts across South East London and Kent has a urology unit with three consultants.

Ian Dickinson, Urology Consultant said, “Patients who use urethral catheters for a long period of time run the risk of infection; therefore the more permanent suprapubic system is better because it practically eliminates this problem.

“Until now we have had to t the suprapubic catheters through the abdominal wall under general anaesthetic, guided by ultrasound.

“I was never really satis ed with the previous catheters as we were using them ‘blindly’ and was attracted to the Mediplus suprapubic system because of the three-stage guide-wire. It allows for controlled entry into the bladder and removes any guesswork.

“This means it is much easier to position the catheter accurately, reducing potential risks to the patient and making the whole procedure much more comfortable.

I believe patients have also bene ted from a more comfortable procedure and I would strongly encourage other hospitals to adopt this technique.

“We are very proud to be the rst hospital in Kent to trial this new system. We hope that our positive experience, and those of our patients, will prove to help the NHS in deciding whether to roll out the Mediplus system UK wide.”

Mediplus Ltd, Unit 7, The Gateway Centre.Coronation Road, High Wycombe,Bucks HP12 3SU Tel: +44 (0)1494 551200 Fax: +44 (0)1494 536333 Email: [email protected] Please quote ‘OTJ’


News, RSS Feed, Blogg, Twitter, Study Days, Links and more at:

New datasheet on VaSera™ VS-1500N vascular screening device from Fukuda Denshi

Fukuda Denshi is one of the world’s leaders in cardiology instrumentation, patient monitoring and ultrasound technologies. One of its key products is the VaSera™ VS-1500N vascular screening device, for which a new datasheet is now available.

The VaSera™ VS-1500N has a colour LCD display, compact ash card slot, LAN connector and printer connector, while weighing only 8kg for easy portability. The new datasheet provides full speci cation and gives details of the vascular indices it measures to help clinicians evaluate the extent of a patient’s vascular disease.

The indices measured by the VaSera™ VS-1500N are:• The cardio ankle vascular index (CAVI), plus detailed value.• The knee cardio ankle vascular index (kCAVI)• The ankle brachial index (ABI)• The toe brachial index (TBI)

The VaSera™ VS-1500N has a built in recorder and external printer, together with a data ling facility and an option to extend measurements from vascular to 12-lead ECG. In this latter mode the VaSera™ VS-1500N can display and print 12 lead ECG reports with the latest interpretation, arrhythmia and R-R interval measurements.

For a copy of the new VaSera™ VS-1500N datasheet, please telephone Fukuda Denshi on 01438 728 065 or visit www.fukuda.co.uk.

Fukuda Denshi: a professional approach from a team of ultra dedicated individuals.

INNOVATIONSH O S P I T A L

Hospital Innovations Limited was founded in January 2008 as a result of key individuals coming together to pool their collective experiences to create what we believe is and will continue to be a truly outstanding company.

HI Ltd is a medical company dedicated to providing medical products to the UK community at primary, secondary NHS levels and the private sector. HI offer world class products with a rst class support package and service. HI offer quick, effective solutions to clinicians, with its broad distribution and client network, to ensure a service which will enhance clinician and patient choice. Our contact base both at regulatory and hospital level is unrivalled and allow us to prepare patient pathways for acceptance of our innovative and clinically effective products.

All our products will have clinical appeal and are and will be state of the art products. We aim to make HI a signi cant company in the medical market whilst maintaining our customer commitment to quality, service and exibility.

Managing Director, Phil Davies, has been directly involved within orthopaedics since 1983 and in that time has worked for some of the Worlds leading companies. Our intention is to deliver products and services to the orthopaedic community in a way that is both innovative and sustainable.

Sales and Marketing Director, Kevin Edwards, has over 20 years experience and has an extremely in-depth knowledge of the area of tissue and cell regeneration. Kevin will be responsible for delivering our wide range of products through a highly skilled network of specialists.

Our product range is well established yet incorporates leading edge technology, design and implementation. Our approach to service, support and training is the cornerstone of our company’s philosophy.

We hope you will be part of our success and we give you our assurances that Hospital Innovations Limited will truly be one of the most innovative companies.

We are dedicated to delivering new concepts in patient care and we will do this with total dedication, drive, and a lot of enthusiasm! By making Hospital Innovations customer centric, we are able, through our proactive customer services department, to meet the customers needs consistently at all levels.

Hospital Innovations purpose is to be the best in the industry for superior customer service, innovation, quality and commitment

Hospital Innovations: Willowbrook Technology Park,St Mellons, Cardiff CF3 0EFTel: 0845 8803 545www.Hospitalinnovations.com Quote ‘OTJ’

A mountain to climb to pay for surgical devicesA GROUP of North-East surgeons are taking the unusual step of climbing a mountain in Africa next month to buy sophisticated keyhole surgery equipment for use in their NHS hospital.

The consultants, from The James Cook University Hospital, in Middlesbrough, have insisted that they are doing this for fun, and not because the NHS will not stump up the cash.

Despite these assurances, the immediate past president of the Association of Laparoscopic Surgeons, Mike Parker, has expressed concern that many hospitals around the UK are using out-dated surgical instruments because the NHS is strapped for funds.

He said the NHS should be paying for new surgical instruments rather than relying on surgeons to raise the money.

Consultants Jo Cresswell, David Chadwick and Monica Hansrani, plan to climb Mount Kilimanjaro to raise money for the sophisticated equipment.

The expensive instruments are needed to support the development of minimally invasive surgery for patients in Teesside and North Yorkshire.

The trust already has an established laparoscopic (keyhole) surgical service, with surgeons regularly using the techniques to treat kidney and prostate cancer, but keyhole surgery requires lots of expensive specialised instruments.

The ascent of the Tanzanian mountain will take the group more than six days and in the climb of 19,340ft they will have to cope with altitude sickness.

Miss Cresswell said: “We have been very well supported.

“The trust has been very generous, and we have up-to-date equipment. This is happening because I really fancied climbing Kilimanjaro and asked a few friends to join me.”

Mr Parker, whose association is shortly to publish an online guide to keyhole-surgery centres in the UK, which will identify centres which are using outdated equipment, said: “I think it is almost unique for surgeons to do this sort of thing to pay for bread and butter equipment.

“It shouldn’t be their responsibility to pay for this. It really is the responsibility of the health service to provide theatre equipment of suf cient quality to allow surgeons to do advanced laparascopic surgery.”

A spokeswoman for the South Tees Hospitals NHS Foundation Trust said: “The NHS is having to watch what it spends now. By doing this they can help the trust and set themselves a challenge.”

You can sponsor the team by visiting justgiving.com/cuttingedge or you can send contributions to Miss Cresswell’s secretary, Dept of Urology, The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW. Cheques should be made payable to South Tees NHS FT.

Source: The Northern Echo

Quote ‘OTJ’

For further information 01244 660 954

www.melydmedical.com

© 2010 Allen Medical Systems, Inc. All Rights ReservedD-770567-A1 July 26, 2010

Arthroscopic Positioning Devices from Melyd Medical

Allen Wrist Tower System™

Wrist arthroscopy positioning utilizing finger traps

Allen Shoulder Suspension System™

Shoulder arthroscopy in the lateral position

Allen Intraoperative Arm Positioner™

Shoulder arthroscopy in the beach chair position

Allen Leg Holder™

Knee arthroscopy positioning


NEW LIMB HOIST EASES THE LOAD FOR HEALTHCARE PROFESSIONALSWith manual handling accidents accounting for 40% of sickness absence leave in the NHS and costing an estimated £400 million each year, it is clear to see why the latest in leg hoists - MiniLim® - is already receiving far-reaching recognition from healthcare professionals.

Constantly supporting heavy limbs causes painful strains, which explains why one in four Healthcare Professionals is forced to take time off due to back injuries sustained at work. The MiniLim® is designed simply and speci cally to provide precise control for lifting limbs and in particular, legs.

MiniLim® eliminates the physical strain on healthcare workers doing the job of lifting and holding limbs in place stabilising the leg’s position for medical procedures and causing less pain to the patient with sudden movements.

The MiniLim® is designed from the ground up to be used in a wide range of clinical and surgical procedures, including raising and holding for prepping in theatre, limb suspension during surgery, in fracture clinics as well as for a wide range of other procedures where limb suspension my be required, such as ulcer dressing, podiatry and woundcare.

The MiniLim® can also be used in Care Homes and GP Clinics; with its slim pro le and lack of trailing wires minimising risks and making it easy to manoeuvre.

The easy to clean hoist stands at 1.5m high extending to over 2m and is speci cally designed to t with Salitas’s range of disposable slings; offering solutions to a variety of bespoke circumstances and handling even the most severely bariatric patients.

Showcased at the Moving and Handling exhibition in January and at the annual conference of the Association of Orthopaedic Practitioners in May , MiniLim® was well received by both Moving and Handling Professionals and Orthopaedic Practitioners, both of whom are looking for a solution to the ever-increasing problem of back injuries in the healthcare sector. Attracting interest from healthcare professionals around the world – as far a eld as Bermuda and Australia – MiniLim® is increasingly being viewed as a genuine breakthrough.

Richard Wilson, Managing Director, Salitas, said: “Research has shown that the use of a Suspension Stand/Sling combination can signi cantly reduce the manual handling risk involved in the leg lifting and sustained hold processes. Acting on this we have developed MiniLim® to eliminate much of the holding currently creating problems to healthcare professionals as well as possible discomfort to the patient.

He added: “We have already had interest from across the globe and are looking forward to putting the products in place and hearing how we are helping.”

Further information contact: 01423 796157 or Email: [email protected] When responding please quote ‘OTJ’

National Survey Praises

Musgrove’s Work On Hip FracturesA report from the independent National Hip Fracture Database has praised the work of the orthopaedic department dealing with hip fractures at Musgrove Park Hospital in Taunton.

Hip fractures are very common, especially in elderly patients, and the survey placed Musgrove as second in the entire country for a range of indicators of best practice.

Tarun Solanki is a consultant physician at Musgrove working with the Care of Older People Team. He said “This is very good news and shows how hard the whole team has been working over the last year. We were placed at best in ve of the nine domains that were measured and second in a further two. Crucially, we are now getting patients to theatre for their operations very quickly - this is important in getting people home and back on their feet”

Andrew Kelly, consultant orthopaedic surgeon, said “With an increasingly elderly population this work is becoming more and more signi cant. We have made great efforts to prioritise the work on hip fractures and are very pleased with these ndings. “

Marjorie Kerry, 86, fell at her home in Minehead last Saturday and was brought into Musgrove Park by ambulance. She said “Everyone was very nice. I was brought up to the ward very quickly and then they operated on my hip on Sunday morning. I have now had physio and I hope to be going home later today”.

New plaque honours medical

pioneerA PLAQUE marking the remarkable career of a Curran Road-born medical professional has been erected by Larne Historical Society.

A ceremony was held at 4 Barnhill Terrace - now 10 Curran Road - the birthplace of Sir Ivan Whiteside Magill, who was born on July 23, 1888.

This distinguished gentleman was internationally famous for his involvement in much of the innovation and development of modern anaesthetics. Many of the techniques and equipment he devoted are still in use today.

Source: Larne Times

Vale Hospital brings digital technology to South WalesWales is rmly on the surgical map with Vale Hospital becoming the reference centre for the most advanced surgical theatres of their kind in the UK. The two custom-designed fully digital theatres have been installed in the new Vale Hospital, in the Vale of Glamorgan, near Cardiff, which opened on 1st June 2010.

The operating theatres which were custom-designed and installed by Smith & Nephew will bene t the patient and the surgical team, and are designed to improve ef ciency throughout the hospital.

The system utilises the latest digital technology with all of the equipment suspended from the ceiling. Full high de nition (HD) technology with 1920 x 1080 resolution will allow surgeons to see things with greater clarity than is possible with current technology, making complex procedures such as keyhole surgery - far easier. The theatres will also enable high quality video signals to be sent within the theatre or around the hospital in real time.

The Vale Hospital is the rst in Wales to use Integration Broker technology which will allow the surgical team access to video and patient information including a patients Electronic Medical Record (EMR) at the touch of a button. This will improve work ow in theatre by allowing the surgeon to see x-rays, images and other patient documents. There will also be the option to share images between theatres, giving surgeons wider access to consultation and communication with other professionals.Commenting on the state-ofthe-art technology that will be available, Consultant General Surgeon, Tim Havard says: “The High De nition picture quality will be of great bene t and allow for complex surgery to be carried out far more easily. It will also be very helpful to have instant access to x-rays and other patient information; this will be displayed on big screens within the operating theatre and will allow myself and my colleagues to have all the information we need at our ngertips.”

The theatres and equipment at the Vale Hospital have been custom designed and installed through close consultation between Smith & Nephew and Vale Healthcare.

As well as being technologically impressive, the theatres also include ipod docking stations to create a stimulating work atmosphere for the surgeons. The theatres are larger than average, and also provide surgeons with a rare glimpse of daylight.Lis Neil, Chief Executive of Vale Healthcare, says, “The installation of the most technologically advanced digital operating rooms at the Vale Hospital shows our dedication to providing our surgeons with the best equipment possible.“The state-of-the-art theatres also demonstrate the way we are taking health provision in Wales forward. We are committed to providing the best in healthcare for our patients who have undoubtedly bene tted from the digital theatres when the Vale Hospital opened in June this year.”


This intelligent software can also call in accessories from other manufacturers to complement the TRUMPF products. C-arms, infusion standards or anaesthesia equipment for example can all be easily imported.

TruTops Visual can then insert virtual surgeons, specialists and nursing staff to create a realistic work situation. This allows everyone involved to get a good appreciation of workspace ergonomics and, for example, to determine the ideal lengths of ceiling pendants in both working and parked positions.

All TRUMPF products are designed for purpose from standard elements and TruTops Visual 2.0 is the ideal tool for specifying the best, bespoke con guration for the job. The library of parts that form the product database are designed to speci c UK standards in accordance with Healthcare Technical Memorandum (HTM) Rules.

The resultant TruTops Visual layout can then be exported as a .pdf le to all parties complete with dimensions of the room and the equipment. The latest version of this software also makes a TruTops reader freely available, allowing the customer to view the proposed plan from different perspectives in real time.

When it comes to creating the optimum operating theatre or intensive care unit, planning is everything. The medical technology company, TRUMPF, goes to great lengths to ensure the success of this vital ingredient. Most quality suppliers have dedicated planners but TRUMPF has its own, in-house healthcare architect and he has at his disposal a range of software tools to assist in the planning process.

One that is unique to TRUMPF is TruTops Visual and the latest version of this software has just been released. First introduced in 2007, this product has been continuously developed to provide the best in practice-centred planning. It is graphic, quick and highly exible and ensures that work ow is optimised right from the start of the process. It helps the design team to use space to the best advantage, ensure the most ergonomic placement of equipment, identify bottlenecks and avoid planning errors.

The design team can equip an operating theatre with realistic, true-to-scale elements and see their spatial relationship. Every object can be displayed from any angle, placed anywhere, moved, adjusted and orientated in real time until the best position and con guration is found. There’s no time-wasting rendering involved.

REAL-TIME 3D PLANNING OF THEATRES AND ICUs

TRUMPF - Tel: 0844 482 0188 Email: [email protected] Website: www.uk.trumpf.com When responding to articles please quote ‘OTJ’


Now there’s more time to do what you do best: deliver outstanding nursing care.That’s because you’ll be working with elective cases only. So forget the constantdistractions of on-call demands. Instead, be part of a forward-thinking team atone of our state-of-the-art Independent Treatment Centres.

It’s an exciting opportunity to join a business that’s transforming healthcare,reducing waiting times and creating an exceptional experience for every patient.It’s also a chance to take your career forward with one of the UK’s leadingindependent providers.

To find out more, visit: www.careuk.com/theatrenursesThese positions are within NHS Treatment Centres, run by Care UK on behalf of the NHS.

Full and part-time opportunities

Attractive benefits + sign on incentives available

Anaesthetic Nurses/Operating Department Practitioners£26k - £30kMaidstone, Southampton, Ilford, Portsmouth,Haywards Heath and Gillingham

Scrub Nurses£26k - £30kIlford, Southampton, Haywards Heath

Recovery Nurses£26k - £30kMaidstone, Ilford

At Care UK, we actively promote diversity and equal opportunities for all.

Time to do whatyou do best

Regional Theatre Support SpecialistJob Title: Regional Theatre Support Specialist Reports to: Business Manager Department: SalesLocation: Field based

Position OverviewReporting directly to your Regional Sales Manager you will assist the Area Sales Managers in your region by providing, technical interoperative support for Surgeons and Theatre Staff in the safe and effective use of Biomet Products. You will also be required to help with the day to day logistic management within the region.

Principle Purpose of Role• Provide technical support and interoperative support to theatre teams and surgeons• Responsible for maintaining high service levels within hospitals in your region.• To represent the company in a compliant and professional fashion.• Ensure the equipment and implants to be used in surgery are appropriate and complete prior to use

How this will be achieved: Key Tasks• Assist the Area Sales Manager in provide comprehensive technical training and support to surgeons and theatre staff as appropriate e.g. one to one, seminars, workshop demonstrations.

• Advising medical staff at all levels on the bene ts of Biomet products• Interface with internal departments, in particular Customer Care and Marketing Services.• Manage hospital stock levels, consignments (completing appropriate paperwork).• Planning and undertaking learning and development across the Biomet product range.• Attending internal and external training courses to ensure product knowledge is up to date and appropriate.

• Reporting in a consistent and timely fashion as dictated by your Regional Sales Manager.• A exible approach to working hours as dictated by the constraints of hospital and end user requirements.

Key Attributes for the role• Interpersonal skills• Proactive and enthusiastic• Courtesy and Professionalism• Commitment to team• Disciplined and focused• Considerate to others

Skills/KnowledgeRequired• Basic Human anatomy and physiology.• Detailed and comprehensive knowledge of Orthopaedic anatomy, physiology and terminology.• Comprehensive knowledge of Biomet product range.• Knowledge of the Orthopaedic market• Detailed knowledge of key products to ensure safe practice in Theatre.• Sales skills.• Driving License

Desirable• Healthcare background• IT skills• Clean Driving License

Contact: Sarah Jones, HR & Recruitment Of cer, Biomet Healthcare UK LtdTel: 01656 674211 (direct)Email: [email protected] Website: www.biomet.com

In safe hands? Reducing errors in the operating teamWednesday 8 December 2010Venue: Royal Society of Medicine, 1 Wimpole Street, LONDON, W1G 0AEOrganised by the Royal Society of Medicine in association with Patient Safety Section of the Royal Society of Medicine Surgery Section of the Royal Society of Medicine The Royal College of Surgeons of Edinburgh

Participating Sections:Patient Safety Section, Surgery Section

Background: Patient safety is high on the agenda and especially when in situations such as under the knife one wonders whether s/he is in safe hands.

Aim of the symposium: This one day conference aims to:- raise awareness of the current patient safety issues within the operating team- identify the reasons why errors occur- recognise how these errors can be reduced.

Learning objectives:By the end of the conference delegates will- understand how and why errors occur within the surgical team- understand the importance of human factors in reducing errors within the surgical team- recognise key strategies which help to avoid errors within the surgical team- provide the theatre team with an understanding of the cause and effect of surgical error and provide better recognition of the effects of human factors on performance.

Who should attend?Consultant and trainees from all surgical specialties (including obstetrics and gynaecology)Consultant and trainee anaesthetistsTheatre nurses and advanced scrub practitionersHospital Managers and Medical DirectorsRegistration Details: RSM Early bird Retired Fellow: £100RSM Early bird Student: £30RSM Early bird Trainee: £100RSM Early bird Associate: £100RSM Early bird Fellow: £125Early bird Student: £40Early bird Trainee: £115Early bird AHP/Nurse/Midwife: £135Early bird Consultant/GP: £225Dinner: £38CPD (Applied for)Further information Telephone 0207 290 3946 or visit http://www.rsm.ac.uk/academ/safehands.php

The Operating Theatre Journal

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