Department of Surgery, University of Melbourne, Epping, Victoria, Australia.
Division of Surgery, Northern Health, Epping, Victoria, Australia.
ANZ J Surg. 2024 Jun;94(6):1000-1010. doi: 10.1111/ans.18770. Epub 2023 Nov 20.
Climate change is projected to become the leading cause of adverse health outcomes globally, and the healthcare system is a key contributor. Surgical theatres are three to six times more pollutant than other hospital areas, and produce anywhere from a fifth to a third of total hospital waste. Hospitals are increasingly expected to make operating theatres more sustainable, however guidelines to improve environmental sustainability are lacking, and previous research takes a narrow approach to operative sustainability. This paper presents a narrative review that, following a 'review of reviews' approach, aims to summarize the key recommendations to improve the environmental sustainability of surgical theatres. Key domains of discussion identified across the literature included minimisation of volatile anaesthetics, reduction of operating theatre power consumption, optimisation of surgical approach, re-use and re-processing of surgical instruments, waste management, and research, education and leadership. Implementation of individual items in these domains has seen significant reductions in the environmental impact of operative practice. This comprehensive summary of recommendations lays the framework from which providers can assess the sustainability of their practice and for the development of encompassing guidelines to build an environmentally sustainable surgical service.
气候变化预计将成为全球不良健康结果的主要原因，而医疗保健系统是一个关键因素。手术室的污染程度比其他医院区域高出三到六倍，产生的医院废物量占总废物量的五分之一到三分之一。医院越来越需要使手术室更加可持续，然而，改善环境可持续性的指导方针却缺乏，并且之前的研究对手术的可持续性采取了狭隘的方法。本文介绍了一篇叙述性评论，该评论采用了“综述综述”的方法，旨在总结改善手术室环境可持续性的关键建议。文献中确定的主要讨论领域包括最小化挥发性麻醉剂、减少手术室电力消耗、优化手术方法、重复使用和再处理手术器械、废物管理以及研究、教育和领导力。在这些领域实施个别项目已经显著降低了手术实践对环境的影响。这些建议的综合总结为提供者评估其实践的可持续性以及制定全面的指导方针以建立环境可持续的手术服务奠定了框架。
