Screws and implants in Screw Caddies

[Anonymous]

Hi Everyone,

Thanks, John, I am grateful that you have raised this issue on the forum.

Concerns about reprocessing screws in screw caddies are longstanding and as my colleagues have pointed out in their responses, very challenging to address, particularly in light of push back from orthopaedic and other surgeons that utilise kits that include screws and other implants alongside the instruments used to insert them.

As flagged by other respondents and yourself, some countries have moved towards single use implants, in fact Scotland led the way on this back in 2006/2007, however even in Scotland, not all screws and implants are individually packaged at this point.

I have found that apart from resistance being dollar driven and there being concerns re lack of space to store all the implants, surgeons pushed back saying individually packaged screws pose a risk to patient safety and even published papers to try and prove their theory!

When studying for my MSc in Medical Device Decontamination, I decided to undertake my dissertation on this topic, and I have presented on my findings at several decontamination [sterilisation] sciences conferences around the globe. I am yet to write a paper for publication on my findings, but it is on my list of things to do.

I have attached here a copy of one of these presentations, delivered at the Canadian Association for Medical Device Reprocessing Conference in 2016 for reference. I would greatly appreciate it if you use this presentation for any purpose, acknowledgement of me as the source is given.

Whilst I have people’s attention, I would also like to remind those of you that have screw caddies in circulation to make sure that the caddies are restocked prior to being processed through the washer-disinfectors, not in the packaging area prior to sterilisation, as it was very clear that machining residues are present on the unprocessed screws. These residues may or may not be a risk. The data showed that the residues remained on a number of high usage screws but were mostly absent on the moderate usage screws and completely absent on the low usage screws, thus indicating reprocessing removed these residues, although having said that, reprocessing added other, likely less desirable residues instead!

Someone recently asked the question whether those screws that are packaged and sterilised for single use supplied by the manufacturer would have those same machining residues on them – well I cannot answer that, perhaps one of the suppliers might be able to enlighten us?

Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale, VIC Australia 3059

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