Authors' objectives:

To further clarify the risks, the benefits as well as the legal and ethical issues associated with the reutilisation of catheters labeled "for single use only".

Authors' results and conclusions: The risk of infection is not significantly higher with reused catheters than with new ones, provided an effective cleaning and sterilization procedure is followed. Good cleaning and rinsing procedures with pyrogen-free water can also ensure that no more pyrogens or particles are released by a reused catheter than by a new one. The literature has not demonstrated any effect of reuse on catheter biocompatibility. As for the risk of a catheter breaking during a procedure, mechanical tests on several types of diagnostic catheters sold for single use revealed that they did not become more fragile after multiple reuses. This has to be established for each new type of catheter placed on the market. It is possible that the practice of reuse causes a slight increase in the number of catheters used during a procedure. As for the optimum number of reuse, it is impossible to establish a general rule for all catheters. In practice, with most diagnostic catheters, the annual savings are minimal after five reuses. In the case of balloon catheters, the savings decrease appreciably after three uses. The patient's specific consent to the use of a reused catheter is not necessary if there is no increase in the risk or inconvenience. However, straightforward answers must be given to any questions. The existence of a catheter reutilization policy, if the hospital has one, should never be concealed.

Authors' recommendations: The practice of reusing diagnostic and angioplasty catheters, when governed by a strict, clear and realistic policy and procedures covering all aspects of reuse, including quality control and staff training, does not present unacceptable risks and can be considered as clinically effective as using only new catheters. Such a policy and procedures should be formally and openly approved in each institution in which catheters labelled "for single use only" are reused. Other output or dissemination activity: The conclusions of the report were used by the Health department as the basis for an official stance on reuse on "single-use only" material devices. The position, stating that reuse can be a safe and cost-effective procedure as long as it is governed by a strict, clear, realistic and open policy, was distributed to all hospitals of the province.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/

Year Published: 1993

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Conseil d'Evaluation des Technologies de la Santé du Québec

Contact Address: Conseil d'Evaluation des Technologies de la Santé du Québec, 2021, avenue Union, #1040, Montréal, Québec H3A S29, Canada. Tel: 514-873-2563; FAX: 514-873-1369

Contact Name: aetmis@aetmis.gouv.qc.ca

Contact Email: aetmis@aetmis.gouv.qc.ca

Copyright: Conseil d'Evaluation des Technologies de la Sante du Quebec (CETS)