Importance of clinical textiles in the operating room of the future: Clinical, patient-related, hygienic, economic and ecological aspects.

To create a solid basis for planning and discussion on the operating room of the future, a metastudy was prepared by the Centre for Hospital Management under Prof. von Eiff. This forms the current scientific data basis for the supply with operating room textiles.

Management Summary

The market for clinical textiles has for years been marked by two competing supply systems: Disposable products (made of cellulose and SMMS / PP) and reusable products (made of microfilament and laminate).

In the opinion of procurement managers, the entire area of laundry supplies is apparently regarded as a functionally and qualitatively interchangeable product range, so a pure price and terms policy is decisive for the procurement decision.

Qualitative performance attributes, such as tear strength, hygienic safety, adhesion, thermal regulation effect and comfort when worn play a much more subordinate role in this procurement approach.

This is all the more astonishing as the requirements for hygienic safety increase for the purpose of avoiding postoperative infections (surgical site infections), and the opportunity costs (blocked beds) and the direct costs are high (on average per infection approx. 8,200 Euro).

Reusable clinical textiles have proven superior versus disposable textile products:

• The comfort when worn of operating room gowns (measured against the criterion of “body temperature”) is much higher.
• The reprocessing of reusable textile products is based on a validated method and is thus considered “controlled” and “more hygienic”.
• The robustness of the reusable material permits at least 75 controlled reprocessing cycles.
• Any cost comparison of alternative textile supply systems for the operating room is difficult because of the different cloth sizes offered, the different set configurations and the possibility of cross-subsidising disposable products. When looked at purely based on price, the disposable product is cheaper. If one also considers quality aspects in the sense of a costs-benefits analysis, reusable textile products prove advantageous.

Findings and forecasts:

• Procurement decisions for products used directly in the clinical area on patients will in the future be oriented primarily around the criteria of “hygienic safety” and “handling advantages for the operating room personnel”.
• The aspect of “ecological sustainability” is gaining in significance in the awareness of the population and among politicians. One can expect that a “green hospital” (see the trends in the USA and Singapore, for example) can mobilise economic advantages in the future.
• A raft of cities and communities will professionalise their policies to attract industries and attempt to form industry clusters. An elementary component of this concept is to develop different types of workplaces, service and production structures locally and/or regionally. The demand for reusable clinical textiles is helping to keep value creation (and thus jobs) in the country.
• Reprocessing and repair of medical products are becoming ever more important: this on ecological grounds of conserving resources, but also for cost reasons.

Recommendations:

• Reusable clinical textiles are as a rule far superior under economic, ecological, patient-related, handling and hygienic aspects to the disposable products available on the market (drapes, operating room gowns).
• The hospitals can use the aspect of “ecological sustainability” for marketing purposes.
• In any future “Contract system: “Pay-for-Performance”, the cost-bearers should pay more attention to aspects of hygienic safety and the ecological balance in the contract structuring.
• Given the growing importance of hygienic safety, handling advantages and ecological aspects, any purely price-oriented purchasing strategy is ill-advised. Recommended are procurement decisions oriented around the life-cycle of product costs and product benefits and explicitly considering opportunity and risk costs.
• Under the aspect of “ecological sustainability”, reusable products are far superior to the reusable textile offerings. This both with regard to the eco-balance effects (greenhouse gas potential / product carbon footprint; eutrophication potential / over-fertilisation; potential to form photochemical oxidants/ summer smog) and with regard to the life-cycle inventory analysis factor of “Waste volumes”.
• In contrast to disposable products, reusable textile products can be geared more flexibly to the needs of the user (hospitals) and offer the opportunity to realise process- and handling-effective innovative set configurations quickly in logistics terms.

The complete study can be ordered as a special print against a contribution to the costs under:
studie@der-op-der-zukunft.de