Sustainable surgery: in and out of the operating theatre

Aldoori, Joanna; Hartley, John E.; MacFie, John

doi:10.1093/bjs/znab073

Cited by 14 publications

(26 citation statements)

References 7 publications

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“…12 To put this into perspective, the energy used to operate one OR could be used to power over 2,000 homes in the UK. 24 In response to the dangers of climate change, the Paris Agreement, adopted by over 190 countries, was released by the Intergovernmental Panel on Climate Change and is committed to limiting the increase of global warming to 1.5°C. 1,[25][26][27] According to the WHO, NHS England is the only healthcare system to date that has a published national strategy: the 'Greener NHS programme', addressing the issue of climate change in relation to healthcare and aims to achieve a net zero NHS by 2045.…”

Section: Introductionmentioning

confidence: 99%

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Environmental sustainability in orthopaedic surgery

et al. 2022

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Aims In the UK, the NHS generates an estimated 25 megatonnes of carbon dioxide equivalents (4% to 5% of the nation’s total carbon emissions) and produces over 500,000 tonnes of waste annually. There is limited evidence demonstrating the principles of sustainability and its benefits within orthopaedic surgery. The primary aim of this study was to analyze the environmental impact of orthopaedic surgery and the environmentally sustainable initiatives undertaken to address this. The secondary aim of this study was to describe the barriers to making sustainable changes within orthopaedic surgery. Methods A literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines through EMBASE, Medline, and PubMed libraries using two domains of terms: “orthopaedic surgery” and “environmental sustainability”. Results A total of 13 studies were included in the final analysis. All papers studied the environmental impact of orthopaedic surgery in one of three areas: waste management, resource consumption, and carbon emissions. Waste segregation was a prevalent issue and described by nine studies, with up to 74.4% of hazardous waste being generated. Of this, six studies reported recycling waste and up to 43.9% of waste per procedure was recyclable. Large joint arthroplasties generated the highest amount of recyclable waste per procedure. Three studies investigated carbon emissions from intraoperative consumables, sterilization methods, and through the use of telemedicine. One study investigated water wastage and demonstrated that simple changes to practice can reduce water consumption by up to 63%. The two most common barriers to implementing environmentally sustainable changes identified across the studies was a lack of appropriate infrastructure and lack of education and training. Conclusion Environmental sustainability in orthopaedic surgery is a growing area with a wide potential for meaningful change. Further research to cumulatively study the carbon footprint of orthopaedic surgery and the wider impact of environmentally sustainable changes is necessary. Cite this article: Bone Jt Open 2022;3(8):628–640.

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Section: Introductionmentioning

confidence: 99%

“…12 To put this into perspective, the energy used to operate one OR could be used to power over 2,000 homes in the UK. 24…”

Section: Introductionmentioning

confidence: 99%

Environmental sustainability in orthopaedic surgery

et al. 2022

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“…By streamlining operations, expanding the analysis to different surgical settings, and identifying carbon hotspots as potential targets for reduction, the future of medicine should focus on reducing the operating room's carbon footprint [3]. To reduce solid waste, it is vital to assess new technology from a green standpoint, such as minimally invasive surgery and robotic surgery [5]. Simple recyclables include various plastic, glass, and paper varieties.…”

Section: Resultsmentioning

confidence: 99%

“…Patients should only travel if it is absolutely necessary. It is important to increase the use of outreach clinics that offer telemedicine, video conferencing, day treatments, minor surgery, and endoscopy [5]. Increased safe cycle networks, bicycle instruction in schools, employer support programs for car-free commuting, the promotion of leisure cycling, and urban corridors and islands for safer walking and bicycling are all necessary safer alternatives to the commute [8].…”

Section: Resultsmentioning

confidence: 99%

Sustainable Healthcare to Provide Quality Care in the Surgical Industry in the United Kingdom

Mubarak¹

2023

Cureus

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The surgical industry makes a major contribution to sustainable healthcare. This article aims to critically evaluate sustainable healthcare to provide quality surgical care in the United Kingdom.For this study, a systematic review was conducted using peer-reviewed studies and articles from the United Kingdom related to surgical and anesthetic fields that were published within the last five years. The journal articles were selected based on their relevance to the sustainability and performance of the healthcare system, including risks, and subsequently screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 model screening approach. The findings of the relevant journal articles were then critically evaluated for each theme.A total of 79 studies were retrieved, and 15 of the retrieved studies met the inclusion criteria. Of those, 10 articles evaluated existing sustainability practices, only seven articles discussed significant determinants of quality healthcare, and only 86.67% of the articles highlighted the implications of sustainability. The key predictors of high-quality medical care are effective resource management, the acquisition of a moral surgical team, the provision of professional services, integration, short hospital stays, and low mortality and morbidity rates. Conserving water, optimizing treatment routes and transportation, and creating cultural change were found to be the pillars of high-quality, sustainable healthcare.The concept of sustainability varied between these studies, and limitations on sustainability as a result of reduced mortality, morbidity, and business services were observed. Anesthetic gas emissions from operating rooms continue to have the most detrimental effect on the sustainability of the surgical industry. A significant gap was noted between the available data and their implications.

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“…Of 12,302 publications retrieved and screened from electronic databases and 73 publications that were identified and screened using Google, Google Scholar and hand searches of citations, 122 full-text articles were assessed for eligibility and 48 were excluded (Fig 1). Reasons for exclusion were wrong topic (n = 25) , wrong setting (n = 3) [50][51][52], wrong population (n = 1) [53], unclear population (n = 4) [54][55][56][57], and duplicates (n = 15) (see S1 Table and S2 Data for more detail). Nine conference abstract publications were classified as awaiting assessment [58][59][60][61][62][63][64][65][66] (see S2 Table ).…”

Section: Resultsmentioning

confidence: 99%

The environmental impact of health care for musculoskeletal conditions: A scoping review

et al. 2022

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Background Health care has significant environmental impact. We performed a scoping review to map what is known about the environmental impact of health care for musculoskeletal conditions. Methods We included published papers of any design that measured or discussed environmental impact of health care or health support services for any musculoskeletal condition in terms of climate change or global warming (e.g., greenhouse gas emissions it produces). We searched MEDLINE and Embase from inception to 2 May 2022 using keywords for environmental health and musculoskeletal conditions, and performed keyword searches using Google and Google Scholar. Two independent reviewers screened studies. One author independently charted data, verified by a second author. A narrative synthesis was performed. Results Of 12,302 publications screened and 73 identified from other searches, 122 full-text articles were assessed for eligibility, and 49 were included (published 1994 to 2022). Of 24 original research studies, 11 measured environmental impact relating to climate change in orthopaedics (n = 10), and medical aids for the knee (n = 1), one measured energy expenditure of laminar versus turbulent airflow ventilation systems in operating rooms during simulated hip replacements and 12 measured waste associated with orthopaedic surgery but did not relate waste to greenhouse gas emissions or environmental effects. Twenty-one editorials described a need to reduce environmental impact of orthopaedic surgery (n = 9), physiotherapy (n = 9), podiatry (n = 2) or occupational therapy (n = 1). Four narrative reviews discussed sustainability relating to hand surgery (n = 2), orthopaedic surgery (n = 1) and orthopaedic implants (n = 1). Conclusion Despite an established link between health care and greenhouse gas emissions we found limited empirical data estimating the impact of musculoskeletal health care on the environment. These data are needed to determine whether actions to lower the carbon footprint of musculoskeletal health care should be a priority and to identify those aspects of care that should be prioritised.

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Sustainable surgery: in and out of the operating theatre

Cited by 14 publications

References 7 publications

Environmental sustainability in orthopaedic surgery

Environmental sustainability in orthopaedic surgery

Sustainable Healthcare to Provide Quality Care in the Surgical Industry in the United Kingdom

The environmental impact of health care for musculoskeletal conditions: A scoping review

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