Presentation Description
Institution: Royal Prince Alfred Hospital - New South Wales, Australia
INTRODUCTION
Nailbed injuries are common hand injury presentations. They represent a significant public health, resource, and economic burden. We report the costs of consumables used in a routine nailbed repair to demonstrate the resource expenditure in a public hospital in New South Wales, to highlight the need to optimise resource use to maintain a sustainable future in surgery.
METHODOLOGY
Standard equipment required for a routine nailbed repair, was identified in January 2026. The equipment was further stratified into reusable instruments and consumables. Consumable barcodes were scanned using the NSW Health perioperative healthcare information management system, h-trak, to identify the cost of each consumable. Costs were reviewed and analysed.
RESULTS
14 consumables required for a standard nailbed repair, were identified. The costs of 6 consumable items, were able to be retrieved using h-trak. 8 items did not have a recorded cost when scanned.
Sutures were the most expensive items for NSW Health (Ethicon 8-0 vicryl on spatulated needle, $23.76). Molnlycke’s 10x10cm Mepilex Ag, costed $8.35. Drapes and gauze were the items of least cost - $2.46 and $0.02 respectively. Local anaesthetic, betadine skin preparation solution, normal saline 0.9%, 10mL syringe, drawing up needle, Hypafix, and finger crepe were consumables without a recorded cost on the system.
CONCLUSION
Consumables for a single standard nailbed repair, cost NSW Health a minimum of $54.03. This highlights only a fraction of costs to the public health system that are incurred during surgical management of a nailbed injury. Expenditure associated with initial emergency management, operating theatre, postoperative care, and surgical consultations, add further expense to the NSW public health system. With RACS’ focus on sustainability, further research and quality improvement practices to optimise healthcare costs in hand surgery, while maintaining patient safety, are needed.
Presenters
Authors
Authors
Dr Elysia Jongue - , Dr Ilias Kotronakis -
