The Torix ™ Disposable Marking and Alignment System was developed by Eye Surgeon, Dr Peter Macken (M.B.B.S, F.R.A.N.Z.C.O., F.R.A.CS), to provide fellow surgeons with a low cost sterile Pre-operative marker that facilitates faster workflow.
Torix™ is an ergonomically designed single use instrument which has received full Regulatory Approvals from the TGA and CE Mark Approved. It is in use by surgeons worldwide who have embraced it's efficacy and ease of use.
The Benefits of the Torix™ Disposable Marking and Alignment System
The Torix™ Disposable Marking and Alignment System is packaged sterile and ready to u
se when you are. There is no waiting for instruments to be re sterilised between cases resulting in less downtime for a busy high volume cataract list. Nursing and CSD (Central Sterilising Department) staff are not tied up washing, cleaning, drying, packing and loading of instruments for re sterilisation.
On a busy list of cataract patients the time saving could be as much as one cataract case per list. (Based on a cumulative loss of productivity of 30 minutes per 5 hour list).
The Torix™ Disposable Pre-Operative Marker has been designed to optimally pick up and transfer gentian violet ink fr
om sterile marking pens or ink pads. There is less risk of over inking (obscuring the surgical view). The ergonomic design enables comfortable handling for marking either left or right eyes, at either at the bedside or at a slit lamp. The Torix Disposable IOL Alignment/Axis Guide has been designed to be held comfortably in the non dominant hand by the surgeon, and has marks at 5 degrees, which are clearly visible for the surgeon. Notches are present at 0, 90, 180 and 360 degrees to improve visualization of corneal reference markings.
A proprietary treatment ensures the corneal marks are clearer and more distinct than with conventional metal markers.
Any instrument that is re used is at risk of contamination if there is a breakdown of infection control standards. Items that have been sterilized by low temperature peracetic acid are at risk of contamination if not used immediately after sterilizat
ion (1). Flashing of surgical instruments is only recommended for one off single instrument sterilization eg if an instrument has been dropped and there is no wrapped, sterile replacement available (1). Flash sterilization “should never be used for reasons of convenience such as either an alternative to purchasing additional instrument sets or as a general time saver” (1). Items that have sterilized with a flash sterilizer are at risk of contamination if not used immediately after sterilization. Flash sterilization may also shorten the life span of an instrument, as there is no drying off. There is no risk of contamination with the Torix Disposable Marking and Aligment System, as it is a sterile single use product.
Cross infection with a prion disease such as Creutzfeldt-Jakob disease is a major concern because eyes are a high infectivity tissue (like brain and spinal cord)(2). The Center for Disease Control and Prevention (CDC) guidelines indicate that stringent processing of instruments with sodium hydroxide or sodium hypochlorite is recommended to prevent cross infection with this disease (2). This process may be corrosive to delicate surgical instruments. The Torix Disposable Marking and Alignment System avoids this risk of cross infection of prion diseases, as it is a sterile single use product.
Bibliography
1. Infection Control Guidelines. Policy Directive. NSW Health. PD2007_036, 23-May-2007.
2. http://www.cdc.gov/ncidod/dvrd/cjd/qa_cjd_infection_control.htm. Re usable instruments may cost up to $1,000 per set (for the preoperative marker and the intraoperative axis guide). 5-10 s
ets may be required for a busy unit with an outlay of $5000. Over time these sets are at risk of breaking from the multiple times handling is required, and loss of visible degree lines on the intraoperative axis guides. This will require further instrument set purchases.
Additionally, there is the cost of staff time in washing, cleaning, drying, packing, loading into a sterilizer, unloading and storing instruments, which could add up to one staff hour per list.
Finally there is the cost of a standard autoclave load, which for ophthalmic instruments in a hospital fsteam under pressure (moist steam) autoclave (eg Tangent Series, Atherton sterilizer) is A$100 per load (J. Kanyon, CSD NUM Liverpool Hospital Sydney, personal communication.) If a surgical unit has to do one extra autoclave load to sterilize toric surgical instruments this would be $100 extra per list.