Water-wise hand preparation – the true impact of our practice: A controlled before-and-after study

Potgieter, M; Faisal, Andy; Ikram, A; Burger, Marlette

doi:10.7196/samj.2020.v110i4.14044

Cited by 7 publications

(9 citation statements)

References 10 publications

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“…Three main environmental issues were identified. Nine studies focused on waste management, 18,[39][40][41][42][43][44][45][46][47] three on carbon emissions, [48][49][50] and one on water usage 51 (Table I). The quality assessment of the studies is detailed in Figure 3.…”

Section: Resultsmentioning

confidence: 99%

“…Water usage. Only one study investigated water usage in the orthopaedic OR (Table VII), 51 ORIF, open reduction and internal fixation; PFTR, primary flexor tendon release; TFR, trigger finger release; THA, total hip arthroplasty; TKA, total knee arthroplasty.…”

Section: Resultsmentioning

confidence: 99%

“…Only one study investigated water usage in the orthopaedic OR (Table VII), 51 comparing a standard scrub using water and soap to three different hand washing methods: alcohol scrub (AS), scrub nurse-assisted (SN), and self-wash (SW). SN and SW interventions involved switching water taps off when not in use during the process of scrubbing and used water and soap.…”

Section: Resultsmentioning

confidence: 99%

“…69,70 Studies have further conferred that there was no significant difference in SSI rates between alcohol hand rubs and other methods of hand-washing. 71-73 Potgeiter et al 51 reported significantly less water and time being wasted when using alcohol hand rubs. This study also demonstrated that switching taps off while not in use during the scrub significantly reduced water usage by 59.5% to 65.8%, compared to when taps were running constantly throughout the scrub.…”

Section: Discussionmentioning

confidence: 99%

“…All 13 studies commented on barriers to making sustainable changes within orthopaedic surgery (Table VIII). 18,[39][40][41][42][43][44][45][46][48][49][50][51] The barrier most described by eight of the studies was a lack of appropriate infrastructure to support sustainable changes. Next was a lack of knowledge or training, as described by five studies.…”

Section: Figmentioning

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

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Environmental sustainability in orthopaedic surgery

et al. 2022

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“Water or not water: That is the question.” Analysis of costs and consumption of the operating theaters in a greener perspective

Restaino,

Tius,

Arcieri

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo compare the amounts of water and plastic used in surgical hand washing with medicated soaps and with alcohol‐based products and to compare costs and consumption in a year, based on scheduled surgical activity.MethodThis retrospective study was carried out at Udine's Gynecology Operating Block from October to November 2022. We estimated the average amount of water with a graduated cylinder and the total cost of water usage based on euros/m3 indicated by the supplier; for each antiseptic agent we collected the data relevant to wash time, amount of water and product used per scrub, number of handscrubs made with every 500 mL bottle and cost of a single bottle. We put data into two hypothetical contexts, namely WHO guidelines and manufacturers' recommendations. Data were subjected to statistical analysis.ResultsThe daily amount of water using povidone‐iodine, chlorhexidine‐gluconate and alcohol‐based antiseptic agents was 187.6, 140.7 and 0 L/day (P value = 0.001), respectively; A total of 69 000 L/year of water would be saved if alcohol‐based products were routinely used. A single unit of an alcohol‐based product allows three times as many handscrubs as any other product (P value = 0.001) with consequent reduction in plastic packaging.ConclusionDespite the cost saving being negligible, choosing alcohol‐based handrub over medicated soap handrub – on equal antiseptic efficacy grounds ‐ could lead to a significant saving of water and plastic, thus making our operating theaters more environmentally friendly.

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