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Cost and Utilization Analysis of Operating Room Instruments in Plastic and Reconstructive Surgery
Miguel I Dorante, MD, MBE¹, Maria J Escobar-Domingo, MD², David L Tran, MD³, JacqueLyn R Kinney, MD², Natalie L Kuhn, MD¹, Michael F Cassidy, BA³, Michelle Park, MD⁴, Evan S Garfein, MD, MBA⁴, Ernest S Chiu, MD⁵, Bernard T Lee, MD, MBA, MPH², Lifei Guo, MD, PhD^1
1Lahey Hospital and Medical Center, Burlington, MA, USA, ²Beth Israel Deaconess Medical Center, Boston, MA, USA, ³New York Langone Health, New York, NY, USA, ⁴Montefiore Medical Center, Bronx, NY, USA, ⁵New York Langone Health, New York, MA, USA

Purpose: Right-sized surgical trays reduce operative costs and waste. We sought to assess current opinions of surgical instrument utilization in common plastic surgery procedures.
Methods: Surgeons, residents, and operative staff at four academic hospitals were surveyed using an anonymous, online questionnaire from March to September 2023. Questions explored instrument utilization in breast reconstruction, body contouring, aesthetic and gender affirming surgery.
Results: Out of 59 respondents, 36 completed surveys (response rate, 61%), half were surgeons and residents, and a third were in practice for ≥10 years. Two-thirds of respondents indicated that <50% of opened instruments are utilized per case, except in autologous breast reconstruction. More than two-thirds of respondents would either ‘always’ recommend right-sized trays or are ‘likely’ to. Even when considering ramifications of right-sizing, >60% of respondents indicated that overall instrument reprocessing costs would either moderately or greatly decrease if right-sized trays were used.
Conclusion: Findings suggest plastic surgery staff are cognizant of unused resources and support right-sizing for common plastic surgery procedures, placing emphasis on need to implement sustainable methodologies to optimize operative efficiency.

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