ACCUFUSER® : Plastic/Aesthetic Surgery

The Pump for Plastic/Aesthetic Surgeons

Consider a Better Alternative for Post-Op Pain Control

More than ever, patients are going home earlier following surgery. Now you can provide more effective management of your patients’ post-operative pain using the ACCUFUSER® Post-Op Pain Control Pump from Curlin Medical.

Compared to systemic narcotic medications, the portable ACCUFUSER® pump delivers post-operative analgesia directly to the surgical site by continuously infusing non-narcotic local anesthetic into the wound through an indwelling catheter.

Clinical experience with this technique shows both a significant reduction of post-operative pain and significantly reduced usage of narcotic medications, resulting in greater patient satisfaction. Surgeons have found that the technique is safe, more cost-effective and easier to administer than epidural or intravenous alternatives.

While systemic opioids affect the entire body raising the risk of side effects, continuous local anesthesia targets the surgical site directly. This helps reduce the chance of systemic side effects.

Designed for Better Relief & Patient Satisfaction

The ACCUFUSER® pump is a small disposable infuser that connects to the Curlin Saturation Catheter™. The Saturation Catheter™ is specially-designed with a pattern of tiny holes supplying superior distribution of analgesic to the surgical area. The catheter is inserted during surgery and the incision is closed. When the pump is activated, the catheter bathes the surgical wound with continuous local anesthetic for two to five days.

For enhanced satisfaction, patients can use the pump’s optional bolus-dose button to self-deliver additional local anesthetic before activities or during periods of increased pain.

Upon the conclusion of therapy, the catheter removes easily and the pump is discarded.

Simple to Set Up & Use

Your staff can fill, prime and prepare the ACCUFUSER® system quickly and easily. Placing the catheter is also a simple procedure.

Non-electronic and easy to operate, the ACCUFUSER® pump requires minimal staff or patient training. Fluid delivery is automatic and patient intervention is minimal. For example, infusion progress can be monitored by simply checking the medication level on the pump reservoir’s graduated scale.

A carrying pouch lets patients take the lightweight ACCUFUSER® pump with them anywhere they go during their recovery (not available for 100mL pump).

Demonstrated Efficacy in Numerous Studies

Numerous clinical studies demonstrate effective post-operative pain management using the technique of continuous local anesthetic infusion delivered through wound catheters from a medication pump.

Liu et al conducted a definitive meta-analysis of clinical studies to evaluate the efficacy and safety of the technique, reporting their results in the December 2006 Journal of the American College of Surgeons.¹ Forty-four randomized controlled trials were reviewed, representing 2,141 patients undergoing various procedures. The results were favorable for continuous local anesthetic infusion in the surgical wound, including these specific findings:

• Significant decrease in post-operative pain
• Significant reduction in narcotic use
• Significantly-reduced PONV
• Decrease of 1 day in average length-of-stay
• Excellent patient satisfaction

Besides continuous infusion, the ACCUFUSER® PLUS pump provides a bolus-dose button that patients can use to self-deliver additional local anesthetic if needed. Clinical research shows that patients given continuous local anesthetic combined with bolus dosing receive equivalent or superior analgesia and use less pain medication, compared to patients given continuous-only or bolus-only infusion.²

Established Safety for the Patient

Reports of complications remain low after several years of widespread use of continuous local anesthetic infusion for a variety of surgical procedures. Evaluating its safety in their recent meta-analysis, Liu et al¹ found these two results in the clinical literature:

• 0.7% infection rate vs 1.2% control & non-catheter rates
• No cases of local anesthetic toxicity

In other studies, local anesthetics have been observed to produce an antimicrobial effect that may help explain the low incidence of surgical site infection.^3-5

Local anesthetics are generally safer than narcotic analgesics, whose systemic action in the body raises concerns such as the potential for abuse. Decreasing the use of opioids after surgery reduces numerous side effects that can delay hospital discharge, such as respiratory depression, drowsiness and sedation, nausea and vomiting, pruritis, urinary retention, ileus and constipation.⁶

A Safe System Design

The ACCUFUSER® pump delivers a safe, accurate infusion without the complexity and error potential of user-programmable electronic devices. A range of models are available with factory-set flow rates and bolus-dose lockout times that cannot be changed from your prescribed choice. The highest flow rate available is 10 mL/hr, making gross over-infusion unlikely.

Absolutely latex-free, the ACCUFUSER® pump poses no risk of latex sensitization or exposure to latex-sensitive patients.

Proven Cost-Effectiveness in Patient Care

The key to cost reduction in healthcare today is earlier movement of patients out of the PACU, hospital or surgery center. In this environment, you’ll gain many cost-saving benefits using the portable ACCUFUSER® Post-Op Pain Control Pump to implement the technique of continuous local anesthetic infusion in the surgical wound.

Cost-saving benefits demonstrated in clinical research^7-10 include:

• Decreased Length Of Stay (LOS)
• Decreased PACU time
• Earlier return to activities of daily living
• Fewer readmissions

In one randomized controlled study, Dowling et al reported a savings of 8% in hospital costs using continuous local anesthetic infusion to control post-operative sternotomy pain.⁷

Compared to expensive I.V. and epidural narcotic therapies, continuous local anesthetic infusion completely eliminates costs associated with monitoring and treatment for narcotic side effects, and narcotic tracking and disposal.

Proven Reimbursement Assistance

Convenient, successful reimbursement assistance is a key advantage for surgeons selecting the ACCUFUSER® pump. Curlin Medical’s skilled staff and proven approach will help you, your hospital or ambulatory surgery center, to recapture the costs for the surgical procedures you perform using the ACCUFUSER® pump.

Curlin Medical goes beyond other companies to actually work with payers to obtain pre-authorized reimbursement for both you and your facility before each procedure. This way, we are able to inform you of the patient’s coverage before the surgery date.

Curlin Medical also provides experienced, up-to-date consultation to assist you with billing codes and other issues to facilitate reimbursement, where applicable. If you're and ACCUFUSER® pump customer, get answers to your reimbursement questions by contacting Curlin Medical customer support at 714.893.2200 or support@CurlinMedical.com

Catheter Placement Guides

A series of conveniently-sized, illustrated Catheter Placement Guides show common locations for placing the medication delivery catheters at the surgery site.

• Abdominoplasty
• Breast augmentation

If you’re an ACCUFUSER® pump customer click here to view the guides. If you would like to order printed Catheter Placement Guides, or obtain more information, please contact your Curlin Medical representative, Curlin Medical customer support at 714.893.2200 or support@CurlinMedical.com

ACCUFUSER® Pump Information Materials

The Quick links located to the right offer informational materials supporting evaluation and use of the ACCUFUSER® pump.

Co-Marketing Materials

Curlin Medical can help you make your patients and community aware of the ACCUFUSER® pump and its advantages. Just ask your Curlin Medical representative about the consumer-friendly patient awareness brochure.

ACCUFUSER® Pump System Options

Click here to find the ACCUFUSER® pumps and system accessories that meet your patients' needs.

References:

Of special interest to plastic/aesthetic surgeons:

Lu L, Fine NA¹² • Northwestern Memorial Hospital

• Significantly less narcotics use
• Significantly less pain
• Significantly fewer hospital admissions
• No infections

Other References:

1	Liu SS, Richman JM, Thirlby RC, Wu CL Efficacy of continuous wound catheters delivering local anesthetic for postoperative analgesia: a quantitative and qualitative systematic review of randomized controlled trials. J Am Coll Surg 2006 Dec; 203(6):914-932.
2	Singelyn FJ, Seguy S, Gouverneur JM. Interscalene brachial plexus analgesia after open shoulder surgery: continuous versus patient-controlled infusion. Anesth Analg 1999; 89: 1216 – 20.
3	Parr AM, Zoutman DE, Davidson JS. Antimicrobial activity of lidocaine against bacteria associated with nosocomial wound infection. Ann Plast Surg 1999 Sep; 43(3): 239-45.
4	Sakuragi T et al. Bactericidal activity of clinically used local anesthetics on staphylococcus aureus. Reg Anesth 1996 May-Jun; 21(3): 239-42.
5	Gallos G et al. Local anesthetics reduce mortality and protect against renal and hepatic dysfunction in murine septic peritonitis. Anesthesiology 2004 Oct;101(4):902-11.
6	White PF. The changing role of non-opioid analgesic techniques in the management of postoperative pain. Anesth Analg 2005 Nov;101(5 Suppl): S5-22.
7	Dowling R, Thielmeier K, Aziz G, Barber D, Boice T, Dine A. Improved pain control after cardiac surgery: results of a randomized, double-blind, clinical trial. J Thorac Cardiovasc Surg 2003;126:1271–1278.
8	Zohar E, Fredman B, Phillipov A, Jedeikin R, Shapiro A. The analgesic efficacy of patient-controlled bupivacaine wound instillation after total abdominal hysterectomy with bilateral salpingo-ophorectomy. Anesth Analg 2001 Aug; 93(2): 482-487.
9	Lu L, Fine NA. The efficacy of continuous local anesthetic infiltration in breast surgery: reduction mammaplasty and reconstruction. Plast Reconstr Surg 2005 Jun;115(7):1927-34; discussion 1935-6.
10	Schell SR. Patient outcomes after axillary lymph node dissection for breast cancer: use of postoperative continuous local anesthesia infusion. J Surg Res. 2006 Jul;134(1):124-32.

Professional Links

American Academy of Cosmetic Surgery (AACS)

American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)

American Society for Aesthetic Plastic Surgery (ASAPS)

American Society of Plastic Surgeons (ASPS)