全膝关节置换术的环境影响：医院手术室与门诊手术中心的废物审计
Environmental impact of TKA: Waste audit of hospital operating room compared to ambulatory surgery center.
作者信息
Bejcek Christopher E, Baker Jeffrey R, Sleiman Anthony G, Thuppal Sowmyanarayanan V, Delfino Kristin, Allan D Gordon
机构信息
Division of Orthopedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL, 62794, USA.
Center for Clinical Research, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62702, USA.
出版信息
J Orthop. 2025 Jan 17;68:90-92. doi: 10.1016/j.jor.2025.01.014. eCollection 2025 Oct.
INTRODUCTION
The implications of global warming are ever increasing in today's society. As the number of total knee arthroplasties (TKA) performed in the USA increases annually, the total waste produced from them will proportionally increase. This study hopes to quantify and compare the amount of waste created by a TKA in a hospital operating room (OR) and ambulatory surgery center (ASC) to evaluate for any differences in the amount and types of waste created.
METHODS
Waste audits were performed on 10 TKAs both at hospital OR and ASC OR. Waste was organized into 6 categories: normal solid waste, recyclable plastics, biohazard waste, laundered linens, sharps, and polypropylene blue sterile wrap. Weight and volume for each waste stream were recorded using a digital scale and ruler.
RESULTS
The total mass of waste produced was higher in hospital based TKAs than in the ASC cases (17.3 kg vs. 14.0 kg, p-value = 0.0028). There was significantly more mass of sterile, normal, and sharps waste at the hospital-based cases. Sterile waste was the largest contributor to the mass of waste in both settings. No difference existed in volume of waste between the hospital and ASC cases (305,866 cm vs 260,052 cm, p-value = 0.2494).
DISCUSSION
TKAs in both settings produce a large amount of waste. Performing TKAs at ASCs could be used to lower the amount of waste produced, resulting in long term benefits to both the environment and the healthcare system.
引言
在当今社会，全球变暖的影响日益增加。随着美国每年进行的全膝关节置换术（TKA）数量的增加，由此产生的总废物量也将相应增加。本研究希望对医院手术室（OR）和门诊手术中心（ASC）中TKA产生的废物量进行量化和比较，以评估产生的废物量和类型的任何差异。
方法
在医院手术室和ASC手术室对10例TKA进行了废物审计。废物被分为6类：普通固体废物、可回收塑料、生物危害废物、洗涤过的亚麻布、锐器和聚丙烯蓝色无菌包装。使用数字秤和尺子记录每个废物流的重量和体积。
结果
基于医院的TKA产生的总废物质量高于ASC病例（17.3千克对14.0千克，p值=0.0028）。基于医院的病例中无菌、普通和锐器废物的质量明显更多。在两种情况下，无菌废物都是废物质量的最大贡献者。医院和ASC病例之间的废物体积没有差异（305,866立方厘米对260,052立方厘米，p值=0.2494）。
讨论
两种情况下的TKA都会产生大量废物。在ASC进行TKA可用于减少产生的废物量，从而对环境和医疗系统都带来长期益处。
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