Management of surgical instruments at loaner companies in upper-middle and high-income countries: The other side of the coin


      • Multiple failures to meet recommended practices were detected in loaner companies.
      • Multifaceted loaner system management challenges need to be tackled.
      • Standardised requirements and improvements in process verification are needed.



      The complex and specific surgical instruments (SI) acquired from loaner companies are provided non-sterile and must be reprocessed before each use. We evaluated the management practices of SI in loaner companies in a high (Australia) and a middle-income (Brazil) country.


      Seven company managers in Australia and eight in Brazil replied to the self-administrated survey.


      Failures to meet recommended practices were detected, including standard operating procedure (SOP) provision, minimum delivery time, transport container and decontamination in loaner companies in both countries. Six of seven loaner companies in each country provided SOP for instrument reprocessing (one company in Brazil did not reply). Solicitation of the SI may occur 12 h before need in Brazil, and delivery of the set could be accepted 4 h before surgery in both countries. Transport of SI on stainless steel/aluminium trays was reported by 42.85% and 28.6% of companies in Brazil and Australia, respectively. In Australia, 57.1% of the loaner companies affirmed they performed cleaning only if the SI were visibly dirty. In Brazil, 62.5% of the companies reported they use alcohol to wipe SI.


      There is a need for standardisation of requirements and process verification improvement in loaner SI reprocessing and management.


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