Quantifying the U.s. Surgical Instrument Fleet and Its Reprocessing Burden: Implications for Cost and Sustainability in Healthcare

Sterile surgical instrumentation is an essential component of healthcare delivery. It is widely recognized that there is significant waste in the reprocessing of surgical instruments as the majority of instruments in a given tray go unused yet must be reprocessed. Part of the struggle in understanding the scale of this waste is that there is no accurate statistical estimation of 1) the size of the national surgical instrument fleet, 2) the total number of instruments reprocessed annually, 3) the percentage of instruments that are reprocessed and not used in a given case (idle sterilization), 4) percent of instruments that are rarely if ever used and 5) the annual replacement cost for lost/missing instruments. We present an estimation of these variable based on a statistical sampling of 5.2% of all the operating rooms in the United States and seek to provide a reasonable estimation of the cost of the waste.