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Thursday, 4 January, 2001, 16:36 GMT
Single-use scalpels to combat CJD
Single-use scalpels will be introduced by the autumn
Disposable surgical instruments are being introduced to Scottish hospitals in a bid to reduce the risk of patients being infected with the human form of mad cow disease.

The Scottish Executive has announced that by autumn this year all tonsillectomies will be carried out with single use surgical instruments.

The move is aimed at reducing the chances of patients being infected with variant Creutzfeldt-Jakob Disease (vCJD).

Similar steps are being taken in England and Wales after an expert group recommended all UK health departments consider a move to single-use instruments for this procedure.

It's a very rational and sensible way forward that isn't going to bankrupt the NHS

Professor Hugh Pennington, Aberdeen University
Deputy chief medical officer Dr Andrew Fraser said: "As our knowledge of vCJD increases, then we must also ensure that clinical practices and procedures keep pace with this knowledge.

"Where that requires improvement to take place, we will take action to implement those measures and reduce risk wherever we can."

"We have accepted the expert advice on vCJD and tonsillectomies - as have the other UK health departments.

"We will shortly issue detailed instructions to the NHS in Scotland on how these improvements will be implemented.

"And, as a result, we expect all tonsillectomies to be carried out with single-use instruments by autumn 2001."

Theoretical risk

Around 7,500 tonsillectomies are carried out each year in Scotland - many of them on children and young people.

The move towards single-use surgical equipment has been welcomed by Hugh Pennington, a professor of bacteriology at Aberdeen University and an expert in BSE, the animal form of CJD.

He said: "By focussing this approach on young people who have tonsillectomies, it's a very rational and sensible way forward that isn't going to bankrupt the NHS. "

Hugh Pennington
Professor Hugh Pennington: welcomed move
He said studies had found prions - possibly the infectious agents responsible for vCJD - present in the tonsils of those who had died of the disease, but not in any studies of tonsils removed from the general population.

Professor Pennington stressed that there was a theoretical risk of transmission if the same instruments were used in successive operations.

"That is always a possibility that if you cut into the tonsil of someone who's going to come down with CJD in a year or so."

He said current procedures to sterilise instruments were not strong enough to eradicate prions, and said sterilisation particularly needed to focus on forceps and other instruments that have a blade.

The NHS in Scotland was allocated an additional 3m this year to support improvements in decontamination.

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See also:

28 Apr 00 | Health
CJD tests show no epidemic
21 Dec 99 | Health
CJD: What is the risk?
18 Aug 99 | Medical notes
Prion diseases
02 Aug 00 | Health
CJD dentistry fears played down
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