Sustainability Prize 2 Calculating the Carbon Footprint of Surgical Scrubbing

Cannings, Ella; Kenington, Cleo; Cox, Kofi

doi:10.1093/bjs/znac246.009

Cited by 2 publications

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“…The average water consumption per water/soap based scrub was 18.5l ( 15 ) and carbon footprint of 1 litre of water was taken to be 0.00136927 kgCO2e ( 17 ).…”

Section: Methodsmentioning

confidence: 99%

Time for change: compliance with RCS green theatre checklist—facilitators and barriers on the journey to net zero

Westwood,

Walshaw,

Boag

et al. 2023

Front. Surg.

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BackgroundClimate change is an era-defining health concern, with healthcare related emissions paradoxically compounding negative impacts. The NHS produces 5% of the UK's carbon footprint, with operating theatres a recognised carbon hotspot. NHS England aims to become Net Zero by 2045. Consequently, UK Royal Colleges of Surgery have published guidance to foster an evidence-based sustainable transformation in surgical practice.MethodsA single-centre quality improvement project was undertaken, aiming to provide an overview of sustainable practice locally. The Intercollegiate “Green Theatre Checklist” was taken as an audit standard, focusing on “preparing for surgery” and “intraoperative equipment” subsections. Any general surgical procedure was eligible for inclusion. Usage of reusable textiles, non-sterile gloves, catheters, antibiotics, alcohol vs. water-based scrub techniques, skin sterilisation choices, and skin closure materials were recorded. Baseline data collection occurred over a 3 week period, followed by dissemination of results locally via clinical governance meetings and poster displays. A re-audit of practice was conducted using the same methodology and duration.ResultsDatasets 1 (n = 23) and 2 (n = 23) included open (n = 22), laparoscopic (n = 24), elective (n = 22) and non-elective (n = 24) cases. Good practice was demonstrated in reusable textiles (trolley covers 96%, 78%, drapes 100%, 92%) however procurement issues reduced otherwise good reusable gown use in Dataset 2 in (90%, 46%). No unnecessary catheter use was identified, and loose skin preparations were used unanimously. Uptake of alcohol-based scrubbing techniques was low (15%, 17%) and unnecessary non-sterile glove use was observed in >30% of procedures. All laparoscopic ports and scissors were single use. Carbon footprints were 128.27 kgCO2e and 117.71 kgCO2e in datasets 1 and 2 respectively.ConclusionThis project evidences good practice alongside future local focus areas for improved sustainability. Adoption of hybrid laparoscopic instruments, avoiding unnecessary equipment opening, and standardising reusable materials could reduce carbon and environmental impact considerably. Successful implementation requires considered procurement practices, improved awareness and education, clear leadership, and a sustained cultural shift within the healthcare community. Collaboration among professional institutions and access to supporting evidence is crucial in driving engagement and empowering clinicians to make locally relevant changes a reality.

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“…The average water consumption per water/soap based scrub was 18.5l ( 15 ) and carbon footprint of 1 litre of water was taken to be 0.00136927 kgCO2e ( 17 ).…”

Section: Methodsmentioning

confidence: 99%

Time for change: compliance with RCS green theatre checklist—facilitators and barriers on the journey to net zero

Westwood,

Walshaw,

Boag

et al. 2023

Front. Surg.

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Scoping review for the SAGES EAES joint collaborative on sustainability in surgical practice

Huo,

Eussen,

Marconi

et al. 2024

Surg Endosc

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Background Surgical care in the operating room (OR) contributes one-third of the greenhouse gas (GHG) emissions in healthcare. The European Association of Endoscopic Surgery (EAES) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) initiated a joint Task Force to promote sustainability within minimally invasive gastrointestinal surgery. Methods A scoping review was conducted by searching MEDLINE via Ovid, Embase via Elsevier, Cochrane Central Register of Controlled Trials, and Scopus on August 25th, 2023 to identify articles reporting on the impact of gastrointestinal surgical care on the environment. The objectives were to establish the terminology, outcome measures, and scope associated with sustainable surgical practice. Quantitative data were summarized using descriptive statistics. Results We screened 22,439 articles to identify 85 articles relevant to anesthesia, general surgical practice, and gastrointestinal surgery. There were 58/85 (68.2%) cohort studies and 12/85 (14.1%) Life Cycle Assessment (LCA) studies. The most commonly measured outcomes were kilograms of carbon dioxide equivalents (kg CO2eq), cost of resource consumption in US dollars or euros, surgical waste in kg, water consumption in liters, and energy consumption in kilowatt-hours. Surgical waste production and the use of anesthetic gases were among the largest contributors to the climate impact of surgical practice. Educational initiatives to educate surgical staff on the climate impact of surgery, recycling programs, and strategies to restrict the use of noxious anesthetic gases had the highest impact in reducing the carbon footprint of surgical care. Establishing green teams with multidisciplinary champions is an effective strategy to initiate a sustainability program in gastrointestinal surgery. Conclusion This review establishes standard terminology and outcome measures used to define the environmental footprint of surgical practices. Impactful initiatives to achieve sustainability in surgical practice will require education and multidisciplinary collaborations among key stakeholders including surgeons, researchers, operating room staff, hospital managers, industry partners, and policymakers.

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Sustainability Prize 2 Calculating the Carbon Footprint of Surgical Scrubbing

Cited by 2 publications

References 0 publications

Time for change: compliance with RCS green theatre checklist—facilitators and barriers on the journey to net zero

Time for change: compliance with RCS green theatre checklist—facilitators and barriers on the journey to net zero

Scoping review for the SAGES EAES joint collaborative on sustainability in surgical practice

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