Carbon Neutral Hand Surgery: Simple Changes to Reduce Carbon Footprint

Abstract

Introduction: Rapid climate change poses a major challenge to healthcare. The operating room is especially responsible for carbon emission, with 20% to 70% of hospital waste traced back to the operating room. This literature review aims to suggest changes that can be made in hand surgery for a more sustainable practice. Methods: A literature search was conducted from PubMed, Medline, and other online search engines with the keywords “carbon footprint, environmental health, carbon neutral, plastic surgery, hand surgery, surgery.” Results: “Reduce, Reuse, Recycle, Research, Rethink and Culture” was the framework used to recommend a more carbon neutral practice. In reduction, techniques such as cutting down oversupply of materials, adopting protocols to perform cases in ambulatory settings, and simple measures to reduce energy were identified as valuable methods. Modified sterilization techniques and reprocessing single-use devices were techniques identified for reuse and recycling involved single-stream recycling, staff training, and donation of basic surgical supplies. Research involved adopting data-driven programs for life cycle assessment of all equipment in the operating room, while the use of telemedicine and “green meetings’ were suggested for rethinking. Finally, strategies to encourage a team approach to environmental responsibility were discussed. Conclusion: Carbon neutral practice must be implemented to safeguard sustainable and cost-effective operating rooms and healthcare systems. Hand surgery can pave the way for other specialties through the use of available resources to develop guidelines for carbon neutral practice. This requires active effort from hand surgeons to act as role models for other healthcare professionals.

Commentary: Carbon Neutral Hand Surgery: Simple Changes to Reduce Carbon Footprint

“…2 The conclusion that hand surgery can "pave the way for other specialties" and that hand surgeons can "act as role models" in the movement to carbon-neutral hand surgery is timely and inspiring. 3 This fits with the WHO, 4 and the IPCC 5 goals for mitigation of the current climate crisis and the CMA's net-zero health care goal as part of their "Impact 2040 strategy." 6 As surgeons, we are part of the problem.…”

The environmental impact of health care for musculoskeletal conditions: A scoping review

“…Sixteen reports of included publications were collated with an associated primary report and counted as a single unit to prevent duplication of the same record [ 67 – 82 ] (see Tables 1 and S3 ). Forty-nine primary publications were included in this review [ 83 – 131 ].…”

“…There were 21 editorials with authors from 13 countries; Australia [ 107 – 111 ], Brazil [ 109 ], Canada [ 112 ], Germany [ 109 ], Greece [ 109 ], India [ 113 , 114 ], New Zealand [ 109 , 115 ], Norway [ 109 , 111 , 114 , 116 ], Pakistan [ 109 ], Sweden [ 109 , 117 , 118 ], Switzerland [ 109 , 119 ], United Kingdom [ 100 , 109 , 117 , 120 – 122 ] and United States [ 109 , 116 , 123 – 127 ]. There were four narrative reviews, two from the United States [ 128 , 129 ] and one each from India [ 130 ] and the United Kingdom [ 131 ]. Thirty-six (73%) included publications were related to orthopaedic surgery [ 83 – 104 , 106 , 117 , 120 – 131 ].…”

“…There were four narrative reviews, two from the United States [ 128 , 129 ] and one each from India [ 130 ] and the United Kingdom [ 131 ]. Thirty-six (73%) included publications were related to orthopaedic surgery [ 83 – 104 , 106 , 117 , 120 – 131 ].…”

“…Two narrative reviews summarised environmentally sustainable changes that can be implemented for hand surgery [ 128 , 131 ]. One summarised ‘Lean and Green’ initiatives that aim to reduce waste-energy consumption, improve sterilisation techniques and reprocess single-use devices [ 128 ], and the other summarised changes to reduce the carbon footprint of hand surgery using a ‘Reduce, Reuse, Recycle, Research, Rethink and Culture’ framework [ 131 ]. Both reviews reported financial benefits from implementing environmentally sustainable hand surgery practices.…”