Operating room waste reduction in plastic and hand surgery

Albert, Mark G.; Rothkopf, Douglas M.

doi:10.1177/229255031502300409

Cited by 67 publications

(40 citation statements)

References 3 publications

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“…11,29,30 Efforts to reduce surgical waste throughout the US have shown promising results. Examples of initiative focuses include proper waste sorting, 29,31 recycling blue polypropylene wrap used for surgical equipment sterilization, 30 -32 and streamlining surgical equipment trays and disposable packs. 32 -35 Moving hand procedures from the main OR to the minor OR accomplishes similar goals by minimizing surgical equipment use and reducing disposable material waste, as reported by Van Demark et al 10 Their initiative saved $13,250.42 (US Dollars) and 2.8 tons of waste over a 14-month period including 1099 hand cases.…”

Section: Discussionmentioning

confidence: 99%

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

et al. 2021

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Background: The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal field sterility with Wide-Awake Local Anaesthesia No Tourniquet (WALANT) anaesthesia by evaluating superficial and deep infection rates across a diverse series of cases. Methods: This study was a case series conducted between October 2017 and June 2020. Of all, 217 patients underwent hand/upper extremity procedures performed in a minor procedure room via WALANT technique with field sterility. Primary outcome measures include superficial and deep surgical site infections within 14 days post-surgery. Results: Of all, 217 patients were included in this study; 265 consecutive hand/upper extremity operations were performed by a single surgeon, with notable case diversity. The majority of patients (n = 215, 99.1%) did not report or present with signs of infection before or after their operation. We report 0% 14-day and 0.37% 30-day surgical site infection rates for such hand/upper extremity procedures performed in a minor procedure room with field sterility. Conclusion: Hand/upper extremity procedures performed via WALANT technique with field sterility in a minor procedure room are associated with low surgical site infection rates. These rates are comparable to surgical site infection rates for similar surgeries performed in main operating rooms with standard sterilization procedures. Thus, the implementation of this technique may allow for improved workflow efficiency and reduced waste, all while maintaining patient safety.

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Section: Discussionmentioning

confidence: 99%

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

et al. 2021

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“…[8][9][10][11] In addition, surgeons appear to have limited knowledge regarding the amount and costs of disposable supplies used in the operating room, which often results in waste of materials as supplies are opened and discarded, sometimes unused, after the operation. [12][13][14] For many procedures, minimally invasive laparoscopic surgical approaches have gained popularity as a method of reducing the inpatient stay and expediting postoperative recovery. [15][16][17][18][19][20][21][22] These procedures have generally been associated with increased operative time and use of more disposable and expensive equipment compared to an open approach.…”

Section: Discussionmentioning

confidence: 99%

Cost of open and laparoscopic distal gastrectomy: surgeon perceptions versus the reality of hospital spending

Abraham

Goyert

Kagedan

et al. 2018

cjs

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Background: Rising health care costs have led to increasing focus on cost containment and accountability from health care providers. We sought to explore surgeon awareness of supply costs for open and laparoscopic distal gastrectomy.Methods: Surveys were sent in 2015 to surgeons at 8 academic hospitals in Toronto who performed distal gastrectomy for gastric adenocarcinoma. Respondents were asked to estimate the total cost, type and number of disposable equipment pieces required to perform open and laparoscopic distal gastrectomy. We determined the accuracy of estimates through comparisons with procedural invoices for distal gastrectomy performed between Jan. 1, 2011, and Dec. 31, 2015. All values are in 2015 Canadian dollars. Results:Of the 53 surveys sent out, 12 were completed (response rate 23%). Surgeon estimates of total supply costs ranged from $500 to $3000 and from $1500 to $5000 for open and laparoscopic cases, respectively. Estimated supply costs for requested equipment ranged from $464 to $2055 for open cases and from $1870 to $2960 for laparoscopic cases. Invoices for actual equipment yielded a mean of $821 (standard deviation $543) (range $89-$2613) for open cases and $2678 (standard deviation $958) (range $835-$4102) for laparoscopic cases. Estimates of total cost were within 25% of the median invoice total in 1 response (9%) for open cases and 3 (27%) of those for laparoscopic cases.

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“…• Education for health care professionals on environmental sustainability should include o general knowledge about the climate crisis effects on population health, including 10,11 ▪ air pollution, ▪ exposure to toxins, ▪ heat-related illnesses, 10,11 ▪ extreme weather events, 10,11 ▪ physical and mental health effects of natural disasters, 12 ▪ need for reliable access to clean food and water, and ▪ modification of vector-borne, zoonotic, and waterborne diseases 13 ; o disaster preparedness 10 ; o health system infrastructure resilience [14][15][16][17] ; o supply chain engagement 18 ; o financial, social, and environmental benefits of environmental best practices 19 ; and o real-world examples of environmental best practices in health care services. • Environmentally responsible decision-making in health care delivery should align with local, state and federal regulations and support patient safety and optimal clinical outcomes.…”

Section: Position Statementmentioning

confidence: 99%

“…30 One study found cost feedback to physicians, combined with a small departmental financial incentive, was associated with significantly reduced surgical supply costs without negatively affecting patient outcomes. 19 In addition to supporting public health and well-being, adopting best environmental practices also can deliver triple bottom line returns, 62 which reduce costs, 18 optimize operational efficiency, and enhance patient and worker safety. 35 The health care industry, whose mission is to protect and promote health, contributes to the climate crisis-the greatest health threat of the 21st century.…”

Section: Rationalementioning

confidence: 99%

AORN Position Statement on Environmental Responsibility

2020

AORN Journal

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All health care professionals have an ethical and professional responsibility to protect patients' health through advocacy. [1][2][3] Because human health is affected by and is dependent on the surrounding environment, health care professionals must actively work to incorporate best practices that mitigate negative environmental impact. [4][5][6] • The interdisciplinary health care community serves as a steward of the environment by seeking knowledge about climate and health effects and assessing health care work environments for opportunities to reduce waste, conserve natural resources, and prevent exposure to hazardous materials.

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Operating room waste reduction in plastic and hand surgery

Abstract: Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling.

Cited by 67 publications

References 3 publications

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates

Cost of open and laparoscopic distal gastrectomy: surgeon perceptions versus the reality of hospital spending

AORN Position Statement on Environmental Responsibility

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