Packaging and assembling rib spreaders for trauma procedures

Authored by:
Angie Chisolm, MBA/HCM, BSN, RN, CFRN, TCRN
President and Managing Partner

The Centers for Disease Control and Prevention (CDC) provides guidelines for disinfection and sterilization in healthcare facilities. However, specific instructions for sterilizing rib spreaders (Finochietto Retractors) during emergent open thoracotomy are not explicitly stated; many hospitals’ sterile processing departments (SPD) leave these instruments disassembled when packaging.

This approach raises an important question: How can you ensure staff competency during high-risk, low-volume emergency procedures? In such critical situations, time is of the essence, leaving no opportunity to learn how to assemble rib spreaders.

To address this, hospitals can consider:

  1. Collaborating with your SPD to reassemble and then re-sterilize rib spreaders solely for emergency use.
  2. Training emergency department (ED) staff to quickly and accurately construct disassembled rib spreaders.
  3. Assembling rib spreaders pre-sterilization for emergency-specific readiness.

Research by Mayer et al. indicates that steam sterilization achieves sufficient decontamination, whether instruments are assembled or disassembled, with no heightened risk of infection transmission.

How does your team manage this issue? I would love to hear from you. Please share your practices and any tips you have found effective in ensuring readiness for such critical procedures. Email me your insights!

Reference:

Mayer RR, Bederman SS, Colin VM, Berger MM, Cesario TC, Schwarzkopf R. Risk of Contamination in Assembled vs Disassembled Instruments in Hip Arthroplasty Surgery. J Arthroplasty. 2016 Aug;31(8):1746-9. doi: 10.1016/j.arth.2016.02.004. Epub 2016 Feb 9. PMID: 26948131; PMCID: PMC5922437.