Vu Cindy, Ibarra-Vega Alejandra, Yang Christopher D, Manzanarez-Felix Karlos, Ting Caleb L, Pakvasa Mikhail, Vyas Raj M, Pfaff Miles J
From the Irvine School of Medicine, University of California, Irvine, Calif.
Riverside School of Medicine, University of California, Riverside, Calif.
Plast Reconstr Surg Glob Open. 2024 Aug 21;12(8):e6085. doi: 10.1097/GOX.0000000000006085. eCollection 2024 Aug.
Operating suites are significant drivers of waste, pollution, and costs. Surgeons can help fight the climate crisis by implementing innovative strategies aimed at mitigating the environmental impact of surgical procedures and decreasing operational costs, and moving toward a more sustainable healthcare system. This study aims to review the literature describing interventions that reduce surgical waste.
PubMed, Cochrane, and Embase were searched. Studies reporting interventions to reduce operative waste, including emissions, energy, trash, and other, were included. Case reports, opinion-based reports, reviews, and meta-analyses were excluded. Study quality was rated using MINORS and Jadad scales. Data were extracted from each study to calculate waste on a per case basis. Narrative review of studies was performed rather than meta-analysis.
The search yielded 675 unique hits, of which 13 (level of evidence: I-III) met inclusion criteria. Included studies were categorized by intervention type in relation to the operating and procedure room. Three studies evaluated provider education initiatives, three evaluated setup of instruments, two evaluated single-use items, four evaluated technique changes, and one evaluated surgical venue. Seven studies reported significant reductions in disposable surgical waste throughput, and seven reported significant reductions in cost.
The results of this systemic review demonstrated the effectiveness of surgical waste reduction initiatives in reducing waste volume, cost, and carbon emissions. Within plastic surgery, minimal surgical packs resulted in reduced gross waste and cost while promoting patient satisfaction in hand surgery, supporting the continued development and implementation of such initiatives in a surgical context.
手术室是产生废物、污染和成本的重要源头。外科医生可以通过实施创新策略来帮助应对气候危机，这些策略旨在减轻手术过程对环境的影响、降低运营成本，并朝着更可持续的医疗体系迈进。本研究旨在回顾描述减少手术废物干预措施的文献。
检索了PubMed、Cochrane和Embase数据库。纳入报告减少手术废物干预措施的研究，包括排放、能源、垃圾及其他方面。排除病例报告、基于观点的报告、综述和荟萃分析。使用MINORS和Jadad量表对研究质量进行评分。从每项研究中提取数据，以计算每例手术的废物量。对研究进行叙述性综述而非荟萃分析。
检索共获得675条独立记录，其中13项（证据级别：I - III）符合纳入标准。纳入的研究根据与手术室和手术操作相关的干预类型进行分类。三项研究评估了医护人员教育举措，三项评估了器械设置，两项评估了一次性用品，四项评估了技术变革，一项评估了手术场地。七项研究报告一次性手术废物产出显著减少，七项报告成本显著降低。
本系统评价结果表明，减少手术废物的举措在减少废物量、成本和碳排放方面是有效的。在整形外科领域，最小化手术包减少了总废物量和成本，同时提高了手部手术患者的满意度，支持在手术环境中持续开展和实施此类举措。
