Lopez Lopez Caroline, Reisener Marie-Jacqueline, Kreitz Nikolaus, Kleine-Doepke Veit, Landschoof Sönke, Kühne Christian A
Department für Chirurgie, Schön Klinik Hamburg, Hamburg, Deutschland.
Klinik für Unfall- und Handchirurgie, Schön Klinik Hamburg, Hamburg, Deutschland.
Unfallchirurgie (Heidelb). 2025 Feb;128(2):103-108. doi: 10.1007/s00113-024-01508-z. Epub 2024 Dec 10.
Climate change is a central issue for our future. The increase in the amount of greenhouse gases in the atmosphere promotes the so-called greenhouse effect, resulting in climate change. Worldwide, the amount of plastic waste amounts to approximately 8 billion tons. The healthcare sector is responsible for around 4.4% of global net emissions contributing to the greenhouse effect. Measures to reduce CO emissions within the healthcare sector should be implemented accordingly. To make the issue of plastic waste in the operational sector more visible, in the present study we examined and calculated the packaging waste generated in the treatment of distal radius fractures.
The clinic stocks two different implants (sterile packaging = group I vs. implant tray = group II) for the treatment of distal radius fractures. Over a period of 12 months (July 2022-July 2023), the packaging waste from all surgically treated distal radius fractures was collected and weighed. The time required to retrieve, unpack and provide the implants in both groups (referred to as preparation time) was measured. Patient data were recorded in a dedicated register and statistical significances were calculated.
A total of 124 distal radius fractures were treated. The average age of the cohort was 67.9 years with 74.2% being female. The system with sterile individual packaging (group I) was used for fracture treatment 29 times, while the system with the screw tray (group II) was used 94 times. For treatment with sterile packaging 104.5g of plastic waste and 67.4g of plastic-free packaging waste were generated per operation, while treatment with the implant tray resulted in 21.6g of plastic waste and 12.8g of plastic-free packaging waste (p = 0.0001). The average time for providing the screws in group I was significantly higher at 527.8 s compared to treatment with the implant tray in group II at 138 s (p = 0.0001).
In the present study we found a significant increase in plastic waste when using individually packaged implants. To reduce the production of plastic waste, mandatory guidelines for waste separation in the operating room appear to be sensible. Measures such as the return and recycling of recyclable plastic waste as well as improvements in packaging design and the use of bio-based biodegradable and compostable plastics, represent further possibilities for waste reduction.
气候变化是关乎我们未来的核心问题。大气中温室气体含量的增加引发了所谓的温室效应,进而导致气候变化。全球范围内,塑料垃圾总量约达80亿吨。医疗保健行业约占导致温室效应的全球净排放量的4.4%。因此,应相应地采取措施减少医疗保健行业的碳排放。为了使运营部门的塑料垃圾问题更加凸显,在本研究中,我们对桡骨远端骨折治疗过程中产生的包装废弃物进行了检查和计算。
该诊所储备了两种不同的植入物(无菌包装=I组;植入物托盘=II组)用于治疗桡骨远端骨折。在12个月的时间里(2022年7月至2023年7月),收集并称重了所有接受手术治疗的桡骨远端骨折产生的包装废弃物。测量了两组中取出、拆开包装并提供植入物所需的时间(称为准备时间)。患者数据记录在专用登记簿中,并计算统计学意义。
共治疗了124例桡骨远端骨折。该队列的平均年龄为67.9岁,女性占74.2%。使用无菌单独包装系统(I组)进行骨折治疗29次,而使用带螺丝托盘的系统(II组)进行治疗94次。使用无菌包装进行治疗时,每次手术产生104.5克塑料垃圾和67.4克无塑料包装垃圾,而使用植入物托盘进行治疗时,产生21.6克塑料垃圾和12.8克无塑料包装垃圾(p = 0.0001)。I组提供螺丝的平均时间明显更长,为527.8秒,而II组使用植入物托盘进行治疗时为138秒(p = 0.0001)。
在本研究中,我们发现使用单独包装的植入物时,塑料垃圾显著增加。为了减少塑料垃圾的产生,制定手术室废物分类的强制性指南似乎是明智的。诸如回收可回收塑料垃圾以及改进包装设计和使用生物基可生物降解和可堆肥塑料等措施,是进一步减少废物的可能性。