Latest in sterile operating gear

By MARTIN JOHNSTON, health reporter

About 120 shiny metal trolleys will become the surgical backbone of the country's most specialised hospital.

Rattling around the 20 operating theatres at the new Auckland City Hospital, the specially made stainless steel "case carts" will transport the array of scalpels, forceps and other surgical instruments surgeons use to treat patients.

The carts, costing $2700 for the smaller ones and $3000 for the larger, hold closed metal trays of instruments, some specially assembled to suit the surgeon's preferences, some standardised for more common operations such as tonsil removal.

Some case carts have already started rolling in and out of the new hospital's sterile supply service - a ground floor area housing the latest in surgical washing and sterilising machines - for use at Auckland Hospital next door.

When the new hospital opens, they will travel to and from its theatres on levels 4, 8 and 9 by lift - one for clean instruments going up, one for dirty equipment going down.

The $10 million sterile supply service, also to serve Starship fully and Greenlane partly, is likewise divided into clean and dirty rooms. At the moment there are seven sterile supply units.

Gloved and gowned staff remove used instruments from the carts and hose them down, like restaurant kitchenhands with knives and forks, before sending them through washing machines and sterilisers.

The washers use detergent, water heated to 91C and ultrasound. They take 24 minutes to wash and dry a load.

Three types of sterilisers are used, which employ ethylene oxide, hydrogen peroxide or 134C steam. The steam "autoclaves" take 40 minutes.

The case carts are not sterilised, but staff say they are thoroughly cleaned for 10 minutes in their own special "car-wash" units.

All the equipment passes, as it is being washed, from the dirty to the clean area.

The board's general manager of planning, Nigel Murray, said the new sterile supply set-up, the case carts, and the computer and barcode system used to monitor them through the sterilisation process made the hospital safer for patients.

"We can track the cart and look at how hot the wash was [and other indicators], which improves quality.

"Case carts are a new technology in the United States and Europe. We are the first hospital in Australasia to go to this full extent with the system."

The theatres have equipment to sterilise a few items, and instruments needed at short notice can be sucked up to the theatres in cylinders by a vacuum-driven Lamson tube.

Dr Murray said the hospital had followed the international trend by putting its theatres on the same floors as the associated intensive care units and wards.

This reduced the problem of sick patients having to take slow, bumpy rides from floor to floor in their beds.