CHHM researchers offer clever surgical solution for orthopaedic trauma surgeons in developing countries
Every week Ugandan doctors turn 2 – 3 people with broken bones away from hospitals because they don’t have reliable surgical drills to mend their fractures. For the people who need these surgeries, the result can be lifelong disability, and if the ability to work is limited, lifelong poverty may not be far behind. According to a World Health Organization study, "the socioeconomic impact of injury-related disability is magnified in low-income countries, where there are often poorly developed trauma care and rehabilitation systems."
When bones are fractured, doctors need to drill through the bones at the break site so they can install screws and plates to mend bones back together. No reliable surgical drills, means no surgery.
The Drill Problem
In developing countries like Uganda, Haiti, Malawi, and the Philippines, electricity is not always reliable. In many cases, hospitals have donated drills, but replacement parts aren’t always available and proprietary designs mean the drills are difficult to service and maintain. If the drills are older, manufacturers may not even make replacement batteries for the drills.
When there are no reliable drills available when needed, doctors will use manual drills that resemble eggbeaters. It can take up to 20 minutes to drill a single hole with a manual drill, and it is grueling work. Not to mention, leaving the trauma site open for so long dramatically increases the risk of infection which has life threatening consequences of it’s own.
When you consider that 90% of the planet's car crashes happen in developing countries and only 10% of orthopaedic surgeons work in the developing world, the need for economic and effective surgical solutions is critical.
This problem led a team of Centre for Hip Health and Mobility (CHHM) biomedical engineers at Vancouver Coastal Health Research Institute to ask: “What are the real differences between an expensive surgical drill and a hardware store drill?”
The first difference is price. A typical Canadian Tire drill costs around $150 and a surgical drill costs $30,000. The second difference is cleanliness. A hardware store drill can’t be properly sanitized for surgery. Once the drill has been used, fluids from the patient during surgery are inevitably absorbed into the drill making it unsafe for the next patient.
Other than those differences, a hardware-style power drill can be just as effective as a surgical drill for the simple task of drilling holes in bones during trauma surgery and can drill a hole in seconds and produces a better quality hole than a manual drill.
The Surgical Solution
Sterile Drill Bag Cover Prototype
To reconcile the shortcomings of hardware store power drill, UBC Biomedical Engineers researched, prototyped, and developed a surgical dry bag for drills in partnership with surgical collaborators at Mulago Hospital in Kampala, Uganda. It’s a simple, yet brilliant solution that allows surgeons to use the cheaper, more reliable, and rechargeable hardware store drills by completely covering the drills and sealing them during surgery. After surgery, the bags can be sanitized easily and then re-used.
To date, 12 drill bags have been shipped from the CHHM in Vancouver to surgeons at Mulago Hospital for feedback. According to team member Marianne Black, “the feedback from surgeons in Mulago is key, without their enthusiasm and desire to improve patient outcomes, we wouldn't be able to make the drill cover.” It’s worth noting that the team at USTOP (Uganda Sustainable Trauma Orthopaedic Program), professionals from Mulago Hospital, and the drill cover team are all volunteering their time to this project because they all strongly believe these covers can help to improve surgical care.
The drill bag covers greatly increase the number of trauma surgeries Ugandan surgeons can do in a given week, and greatly reduce the amount of headache in their work as they must either compete with other surgeons for expensive surgical drills or use laborious hand drills.
Putting drill bags in the hands that need them
Using sustainable business practices, CHHM engineers are putting these drill covers in the hands of more surgeons in developing countries, ensuring the proper training and ownership accompanies the product so it can be used effectively.
Dr. Piotr Blachut, VGH Orthopaedic Trauma Surgeon, predicts "this drill cover bag is destined to have a major global impact on surgery in the underdeveloped world. The project has already brought laurels to the University of British Columbia and more are likely to follow.”
Learn more about the drill bag team and follow their progress at www.drillcover.com.
Drill Bag Inventors: Marianne Black, Lawrence Buchan, Mike Cancilla, Elise Huisman, Jeremy Kooyman.
The drill cover bags were developed and prototyped at CHHM by Dr. Tony Hodgson’s Engineers in Scrubs program under the mentorship of Nathan O'Hara, and Drs. Peter O’Brien, Piotr Blachut, and Roger Tam. The engineers worked with surgeons, nurses, and sterile processing staff at both Vancouver General Hospital (through the USTOP team) and Makerere University/Mulago Hospital in Uganda to develop a sterile drill cover.