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Little things can make all the difference

1 April 2008

It is not a cure for cancer or a new sort of laser.  But a cleaner, faster, more secure tube fastening could save the NHS millions of pounds, and thousands of patients discomfort.

Dr Marc Spinoza dreamed it up based on a child’s toy, mortgaged his house to finance it, brought in outside investors, and has won plaudits from senior colleagues across several centres.  What he has struggled to do is sweep the country’s hospitals with the invention.

Modern medicine is about tubes in and tubes out; tubes putting drugs, blood, fluids or nutrition in, or taking liquids out.   (Clinicians call the tubes ‘lines’)  In the NHS’s hundreds of hospitals, thousands of lines in patients are being readjusted and redone each day, adding up to millions of minutes and pounds in a year.

Currently, these lines are secured with sutures, and sticking plaster on the patient’s skin.  If they need to be moved even slightly, or are not done right first time, the whole thing has to be redone, which takes a few minutes and a couple of pounds on sutures and tape.  It’s a small inconvenience to doctor and patient, and a modest cost, which is repeated every day in hospitals round the country.   Everyone just takes it for granted.  It could be eliminated.

Enter Dr Marc Spinoza’s bright idea: the SULL.  A simple braided cover tube goes over the line. It works like the child’s toy, the ‘Chinese finger trap’ – it is easy to put the line in and hard to pull it out.  The SULL doesn’t go into the patient, but it grips the line firmly and is attached by sutures.  However, the SULL can be released if pressed, making the line adjustable, it can be moved in or out of the patient if needed without new sutures.

In one study 44/50 health professionals who had used it, wanted to use it again.  For example Professor Monty Mythen, an intensive care specialist at ICH, said it was “the best new mousetrap in the box”. 

The SULL has being tried in hospitals such as Great Ormond Street, the Homerton, Addenbrookes and Guys for uses as wide as surgical drains and parental nutrition.

As lines puncture the body they are a hazard for infection.   Although no formal evaluation of infection control and SULL has yet taken place, you can wash around the site with alcohol, and there is less handling, and redoing of lines.  Logically, it has to be cleaner and simpler than what is already done.  Each line infection is thought to cost the NHS around £4-6000 in extra drugs and nursing time.

There’s a little drama to how the SULL came to be

Dr Marc Spinoza, who owns the patent, thought of it while fishing

He mortgaged his house to get capital, and has since brought on some individual investors

What he wants now is for a big company to pick it up and stick it on every prepacked line – so people have the choice whether to use it or not.

Its not glamorous, its not high tech.  All it does is save time, money and patient discomfort.  So the question is – why has it not become universal?

Dr Spinoza will spend as long as you have talking through his struggles to make it so. 

Contact information:

GOSH-ICH Press Office: 020 7239 3125
Email: Coxs@gosh.nhs.uk
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Notes to editors

Great Ormond Street Hospital for Children NHS Trust is the country’s leading centre for treating sick children, with the widest range of specialists under one roof.

With the UCL Institute of Child Health, we are the largest centre for paediatric research outside the US and play a key role in training children’s health specialists for the future.

Our charity needs to raise £50 million every year to help rebuild and refurbish Great Ormond Street Hospital, buy vital equipment and fund pioneering research. With your help we provide world class care to our very ill children and their families.