Department of Orthopedics, Sant Joan de Déu Hospital Palma Inca, Palma, Spain.
Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
Int Orthop. 2024 Jul;48(7):1701-1706. doi: 10.1007/s00264-024-06155-y. Epub 2024 Mar 26.
The healthcare industry is a significant contributor to single-use plastic waste, particularly in the operating room (OR). This study aims to assess the volume of plastic waste generated during total hip, knee, and shoulder arthroplasty in the OR and identify areas for improvement.
A prospective transversal study at a tertiary hospital was conducted. All total knee arthroplasty (TKA), total hip arthroplasty (THA), and reverse shoulder arthroplasty (RSA) from April to July 2021 were included. The weight of plastic used during patient preparation, anaesthesia, and the surgical procedure was recorded. To calculate the environmental impact, a calculator generated by the United States Environmental Protection Agency (U.S. EPA) was used.
A total of 68 surgeries were included. The mean weight of plastic used in total was 7.3 kg (SD 0.48), with the highest yielding procedure being TKA. It generated a mean of 7.63 kg (SD 0.28), followed by THA at 7.28 kg (SD 0.43), and RSA at 6.87 kg (SD 0.47). Various scenarios were simulated to evaluate the potential impact of reducing plastic waste. Substituting plastic wrapping with recyclable materials could save 159.6 kg of CO emissions per 100 prostheses. Eliminating non-essential equipment and adopting reusable fabric drapes also showed a significant potential.
The findings highlight the need for environmentally sustainable practices in the OR. In this way, the healthcare sector can contribute to a cleaner and greener world without compromising patient safety.
医疗保健行业是一次性塑料废物的主要贡献者，尤其是在手术室（OR）中。本研究旨在评估 OR 中全髋关节置换术、膝关节置换术和肩关节置换术中产生的塑料废物量，并确定改进的领域。
在一家三级医院进行了前瞻性横断面研究。纳入 2021 年 4 月至 7 月期间所有的全膝关节置换术（TKA）、全髋关节置换术（THA）和反向肩关节置换术（RSA）。记录患者准备、麻醉和手术过程中使用的塑料重量。为了计算环境影响，使用了美国环境保护署（U.S. EPA）生成的计算器。
共纳入 68 例手术。总塑料使用量的平均重量为 7.3 公斤（SD 0.48），产生最多塑料废物的手术是 TKA，平均产生 7.63 公斤（SD 0.28），其次是 THA 为 7.28 公斤（SD 0.43），RSA 为 6.87 公斤（SD 0.47）。模拟了各种方案来评估减少塑料废物的潜在影响。用可回收材料替代塑料包装可以节省每 100 个假体 159.6 公斤的 CO 排放。消除非必要设备并采用可重复使用的织物窗帘也显示出很大的潜力。
研究结果强调了 OR 中需要采用环境可持续的实践。通过这种方式，医疗保健行业可以在不影响患者安全的情况下为更清洁、更绿色的世界做出贡献。
