Division of Oculofacial Plastic and Orbital Surgery, Gavin Herbert Eye Institute, University of California, Irvine, Irvine, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2021;37(5):435-438. doi: 10.1097/IOP.0000000000001891.
To investigate the financial and environmental waste burden of unused disposable surgical supplies and pharmaceutical products in oculofacial plastic surgery at a hospital-based outpatient surgery center.
This descriptive study was performed at a single academic hospital-based outpatient surgery center. Unused pharmaceuticals and disposable surgical materials were recorded for each of 34 consecutive oculofacial plastic surgeries performed by the same surgical team. Pharmaceutical products were grouped as local anesthetic (tetracaine, bupivacaine, lidocaine, and sodium bicarbonate), intraoperative (basic saline solution, methylene blue, and oxymetazoline hydrochloride), or antiseptic/antimicrobial (erythromycin ointment and hydrogen peroxide). Percentage of unused pharmaceutical product and disposable surgical material were calculated and extrapolated to direct costs to the institution and greenhouse gas emissions.
The mean percentage of disposable surgical supply waste per case was 11.6% ($29.32). The mean percentage of pharmaceutical waste was 96.1% ($271.84) for local anesthetic, 71.0% ($163.47) for intraoperative medications, and 26.7% ($2.19) for antiseptic medication. The mean emissions per surgical case for unused disposable surgical equipment and unused pharmaceutical product were 10 and 103 kg of carbon equivalent gases (kg CO2-e), respectively.
Surgical supply waste was nominal, but pharmaceutical waste was considerable in this single hospital-based outpatient surgery center study. There may exist opportunities for quality improvement in waste, especially pharmacologic burden, in oculofacial plastic surgery.
调查医院门诊手术中心眼科整形手术中未使用的一次性手术用品和药品的财务和环境浪费负担。
本研究为单中心、回顾性研究，在某医院门诊手术中心进行。记录了同一位手术团队完成的 34 例连续眼科整形手术中未使用的药品和一次性手术耗材。药品分为局部麻醉剂（盐酸丁卡因、布比卡因、利多卡因和碳酸氢钠）、术中用药（生理盐水、亚甲蓝和盐酸羟甲唑啉）和抗菌/防腐剂（红霉素软膏和过氧化氢）。计算未使用药品和一次性手术耗材的比例，并外推至医院的直接成本和温室气体排放量。
每例手术的一次性手术耗材浪费平均占 11.6%（29.32 美元）。局部麻醉剂的药品浪费平均占 96.1%（271.84 美元），术中用药占 71.0%（163.47 美元），抗菌用药占 26.7%（2.19 美元）。每例手术未使用的一次性手术设备和未使用的药品的排放分别为 10 和 103 千克二氧化碳当量气体（kg CO2-e）。
在本单中心门诊手术中心研究中，手术耗材浪费较小，但药品浪费较大。在眼科整形手术中，可能存在减少浪费（尤其是药物负担）的质量改进机会。
