Osseointegration for lower-extremity amputees, while increasing in frequency, remains in its relative infancy compared with traditional socket-based prostheses.» Ideal candidates for osseointegration have documented failure of a traditional prosthesis and should be skeletally mature, have adequate bone stock, demonstrate an ability to adhere to a longitudinal rehabilitation protocol, and be in an otherwise good state of health.

In comparison, the recommended volume of waterless scrub is 4 to 6 mL per surgeon, per operation-at least 5000 times less than soap-based scrubbing. Evidence for the clinical, operative, and infectious efficacy of alcohol-based, waterless surgical scrub compared with traditional soap-based scrub is extensive. 2,3 Furthermore, alcohol-based hand scrub has been shown to be efficacious in low-resource regions without reliable acctess to sterile water, dramatically reducing global waste and preserving treated water in the areas most likely to experience climate-related deprivation in the coming years. 4 Beyond safety and scalability, waterless surgical scrubbing is estimated to save practices and institutions at least $300,000 per operating room per year in three-member scrub teams, and more in personnel-intensive procedures. 5 Given the robust safety evidence of waterless sterilization, the economic benefits to hospitals, the enormous level of water waste found in this study, and the urgency of the climate crisis, routine soap-based hand scrub begins to approach an antiquated luxury emission that the field of plastic surgery can do without.

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