Single-Use vs Reusable Medical Devices

Trocar Supplies, like most medical equipment companies, offers a full range of reusable and disposable medical supplies. But which supplies are best for your medical practice?

What are Single-Use Supplies?

Single-use supplies are used one time, for one procedure, for one patient. They are not designed to be sterilized and used again. Single-use supplies go to the landfill (in bioprotective packaging) after their one-time use.

Pros & Cons of Single-Use Supplies

Disposable, single-use surgical equipment has several advantages over reusable ones. Here are some of the advantages:

• Eliminates the risk of infection. Disposable surgical equipment, like disposable trocars, eliminates the risk of cross-contamination and infection between patients.
• Lower labor costs. Single-use surgical tools don't have to be cleaned and sterilized after they are used. There is no chance that they will be misplaced on a shelf, or miscounted in inventory.
• Consistent quality. Single-use equipment will meet factory specifications. Each instrument is sterile and ready for use. You don't have to worry about loss of sharpness of the blade.
• Reduced risk of injury for staff. Support staff do not have to handle sharp blades during disinfection and restorage. They are not exposed to infection from used sharps.
• Cost-effective. In some cases, disposable surgical equipment may be more cost-effective than reusable equipment, when you consider overhead costs such as maintenance, repair, and replacement.
• Improved patient safety. Single-use surgical equipment improves patient safety by reducing the risk of infection and cross-contamination. Each patient receives a sterile instrument.
• Convenience: Staff can attend to more profitable tasks than putting instruments in sodium hypochlorite solution and the autoclave, and then using hot steam as a final disinfection step.
• Enhanced environmental sustainability: Some disposable surgical equipment is made from biodegradable materials, which enhances environmental sustainability and reduces the environmental impact of healthcare facilities.

But disposable surgical equipment can pose certain disadvantages.

Disposable surgical equipment creates a larger environmental footprint. There are environmental costs attached to the manufacture of each piece of equipment, as well as its packaging and shipping. Even after considering overhead costs, single-use equipment may be more expensive than reusable supplies. However, see our notes on insurance, below.

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What are Reusable Medical Supplies?

Reusable supplies may be used in multiple procedures on multiple patients. They must be sterilized with heat and caustic agents, but, if they can be sharpened between uses, they retain a useful blade.

Pros & Cons of Reusable Medical Supplies

There are some glaring drawbacks of reusable medical supplies.

• Some infectious agents, such as the prions that cause Creutzfeldt-Jakob Disease, cannot be removed by passing the instrument through an autoclave. Prion diseases are very rare, but they are devastating for patients, physicians, and staff.
• Nickel-titanium blades lose their edge after repeated exposure to steam heat and sodium hypochlorite solutions. A dull blade on a trocar increases the risk of pain, bleeding, and herniation.
• Steam sterilization does not always produce the formation of bacterial biofilms. These agglutinations of microorganisms accumulate between uses, and eventually pose an infection threat to patients.
• Autoclaved carbon steel can deteriorate during the final steam treatment. Heat treatment makes it more susceptible to humidity during storage.

The packaging a reusable instrument comes in has a tremendous effect on its viability in long-term use. Knowledgeable manufacturers can provide containers that essentially eliminate deterioration during storage. But blades need to be inspected for sharpness before each reuse.

There are also significant differences in reimbursement for single-use and reusable surgical tools.

Reimbursement for Single-Use Medical Supplies

Certain single-use surgical supplies, such as trocar tray kits, may be separately reimbursed by the patient's health insurance. Reimbursement rules may differ state by state and for each insurance company, but they are usually posted online.

Since 2020, Medicare has established pass-through codes for the cost of single-use surgical equipment, such as trocars required for a variety of outpatient surgical procedures. The pass-through cost is based on the invoice cost of the surgical equipment. Medicare does not pay for single-use equipment, of course, unless it also pays for the procedure in which it is used.

These provisions were set to expire before 2024, although Congress may extend them.

Reimbursement for Reusable Medical Supplies

Reusable medical supplies are considered durable goods. They are not separately reimbursed by private insurance, Medicare, or Medicaid. However, your office will consider equipment costs and costs of sterilization and storage in setting your fee for the procedure in which you use them.

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What Factors Should You Consider?

Safety

Only single-use surgical equipment is appropriate for use with patients who have communicable bloodborne diseases. Reusable equipment must be stored with inventory control numbers so it can be removed from use if it is found to be associated with infections that appear after the procedure. Physicians also need to establish protocols for handling reusable instruments during sterilization and restorage.

Cost

Insurance, Medicare, and Medicaid reimbursement policies can be the deciding factor in choosing between reusable equipment and equipment for one-time use. Reusable equipment is never reimbursed by the patient's health insurance coverage. Single-use equipment sometimes is reimbursed.

Time

Assistants spend 5 to 10 minutes sending used instruments through sterilization, 8 to 15 minutes allowing instruments to dry, and 2 or 3 minutes to note inventory control numbers in patient records and on instrument containers. Half an hour of your assistant's time can cost more than the instrument they sterilize. However, when you have a light patient load, using your assistant's time in this way can make sense. Never put instruments from multiple patients into the autoclave at the same time. You want to avoid cross-contamination, especially if there is any possibility of contamination that cannot be removed by cleaning with steam and bleach.

Impact on the environment

Last-mile shipping of small packages is a huge burden on the environment. There is no doubt that multiple-use instruments are more "green," but the environmental costs of one sick patient easily exceed the environmental burden of shipping thousands of surgical instruments.

Every physician has slightly different circumstances. Patient load, availability of surgical assistants, and scheduling constraints may mean that the best choice is to stock both single-use and multiple-use surgical instruments to be used as circumstances dictate.

Which Should I Choose? Single Use or Reusable Medical Devices

The best choice in medical supplies always depends on your unique circumstances. But Trocar Supplies can help you make the best choice for your profits and for your patients.