Painful Pitfalls of Surgical Instrument Marking and How to Avoid Them

As advances in surgical techniques and procedures lead to increasingly specialized equipment, hospitals, and surgery centers are managing, cleaning, sterilizing, organizing, and arranging thousands of instruments each day — and millions each year. Without some sort of surgical instrument marking and tracking system in place, it’s very difficult to keep everything organized and ready for action.

There are several kinds of surgical instrument identification techniques and strategies out there, ranging from low-tech paint dips and color-coded tapes to high-tech tools using laser or electrochemical marks synced into advanced software systems. While no one system of surgical instrument marking is completely comprehensive, there are some common pitfalls to avoid when refining your facility’s marking processes or evaluating a new way of tracking and identifying surgical instruments.

Don’t Get Stalled by These Pitfalls

At the volume of instruments, your facility is working with, instrument marking is more than just the latest fad. It’s a way for your facility to stay ahead of the curve and incorporate the most advanced technologies to better support smooth operations and positive patient outcomes.

But there are a few things to consider to ensure you’re not adding hassles or even dangers. For example, some studies have found that low-tech marking techniques using labels or tape can unintentionally expose patients to dangers. There are documented accounts of fragments from these low-tech marks (like pieces of tape or fragments of laminate) breaking off during a procedure and being unintentionally retained within the wound. These have caused infections, blockages, and abscesses.

Fortunately, those examples are rare and many facilities are making the leap to more modern marking techniques. If your facility is considering instrument marking, consider these pitfalls to avoid.

1. Creating marks that won’t hold up.
   Whatever marking system you choose, make sure the marks will withstand the rigors of cleaning and sterilization processes without degrading. Marking with lasers or electrochemical techniques will have more longevity and will work for most surgical instruments.
2. Marking but not commissioning.
   Don’t go through the effort of marking your instrument inventory and then forgetting to input them into your tracking system. That will double the work time and hold you back from the most efficient processes. Commission instruments as you go to ensure all the work is done up front and all the instruments are trackable and usable.
3. Marking implantable items.
   Ensure you aren’t marking items that will end up inside patients. As a safety precaution when undertaking an instrument marking project, keep all implants far away from the marking equipment so there will be no confusion.
4. Cutting into tools.
   This can sometimes happen when marking instruments with a laser machine if the laser focal length isn’t correctly aligned. If the focal length is too close it could start cutting into the metal, leaving gouges that can rust. Some newer plastic tools require adjusting laser settings to match their specific chemical makeup to ensure they aren’t cut into.
5. Wrapping marks around curved surfaces.
   Some instruments are small and have narrow shafts, so it might seem like a good idea to wrap the mark around the shaft. The problem, though, is that some tracking scanners are looking for a 2D image, so they won’t be able to read a wrapped mark.
6. Not washing instruments after marking.
   With electrochemical marking, your team needs to wash the instruments within 24 hours. The electrolyte used to create the marks is acidic and it can start to rust your instruments if you don’t wash it off. While not as critical, washing is still recommended after laser marking.

Preparing for Your Marking Project

So, what should you expect if you decide you want to start or upgrade your instrument marking process? Here are a few things to consider:

• What do you need?  Consider your facility and its needs. Do you need to mark and assemble all your instrument sets? Or can you just try out the system and mark your high-value instruments? As you start a project, make sure you’re able to define your needs.
• What kind of marking will work best for your tools?  Laser, electrochemical, and mechanical instrument marking are the most common. Each has strengths and shortfalls. Odds are, if you want to mark all of your instruments, you’ll need to use a combination of all three.
• How long do you want the project to take?  Instrument marking will have some upfront lift with a lot of coordination from multiple teams throughout your facility. Would you prefer to hire multiple marking technicians to come and finish the job more quickly? Or will it work better with your systems to have a smaller number of instruments processed each day or over the weekend?

Once you decide what your instrument marking project will look like on a large scale, it’s time to consider some of the more detailed parts of the project. These will often be items discussed during a kickoff call, but considering some of these points beforehand will ensure everything is communicated more smoothly.

• Where will the marking technician work? Is there a laser safety room onsite they can use? Or will they need to bring a mobile unit to manage the marking process?
• Who will be the main point of contact to ensure the marking team can work most efficiently?
• What instrument sets will be prioritized for marking?
• How will you commission instruments after they’ve been marked? Will you have the technician connect to your server so instruments are immediately available within your tracking system? Or will they need to store data in a separate server and upload commissioned data in daily batches so it’s available the next day?
• Do you need the marking to be EDA (Equipment Data Acquisition) compliant? (This question is most relevant to Veterans Affairs [VA] hospitals or other government healthcare facilities.)

As you start the process of marking, ensure you have systems in place to get it done in the most efficient way. This could mean having instruments available as soon as the marking technician arrives so they can start immediately. It could also mean having a system to track which items have already been marked, to ensure that you’re not bringing out batches that have already been completed. Whether it’s marking containers with tags, stickers, or some other technique, this will help you optimize time and finish the project as soon as possible.

Leverage Experience and Best-In-Class Tools

Marking surgical instruments isn’t as obtrusive as you might think. Our CensiMark service ensures you have best-in-class options for your instrument marking project. As part of your project, we can send experienced technicians to your site so you don’t need to worry about shipping or lost time transporting instruments somewhere else. You’ll be able to manage the project from your facility or within a mobile marking unit.

CensiMark uses the latest technology to ensure the marking doesn’t damage your surgical instruments and gets them back into rotation as soon as possible. And with your service a Censis team member will commission your marked instruments into CensiTrac, so your instruments will be ready for use when you need them.

Ready to learn more? Speak to an expert today.