Episcissors-60 Economic Impact Evaluation - Case Study
Background
Episcissors-60 ® are fixed angle surgical scissors used for episiotomy during childbirth. They are designed to take away human error in estimating episiotomy angles and achieve a mediolateral cut at 60° to the perineal midline, hence minimising the risk of obstetric anal sphincter muscle injuries (OASIS) which requires surgical correction.` Initial results after the introduction of Episcissors-60 show that the majority of health care professionals achieve desired post-suturing episiotomy angles between 40° and 60°.2
The average rate of episiotomies in England is 15% 3 and the average number of births per NHS trust in England is 4,800 per year, giving rise to approximately 720 episiotomies per trust. 4 The current incidence of OASIS is 40 per 1000 births per year.5 There are significant costs associated with OASIS, quite apart from the impact on the quality of life for the women involved. There are major cost implications for both primary and secondary repairs of OASIS. In addition, the National Health Service Litigation Authority (2012), in their report of 10 years of claims, cite OASIS as being the fourth largest cause for litigation in obstetrics. 9
Episcissors-60 are manufactured by Medinvent Ltd and are now being widely adopted in England, Western Europe and Australia. Fifty NHS trusts in the UK are using Episcissors-60.7 The scissors are available exclusively through NHS Supply Chain and they are eligible for the NHS Innovation and Technology Tariff.
This case study focuses on the potential return on investment of replacing standard episiotomy scissors (usual care) with the use of Episcissors-60, to undertake episiotomy during childbirth.