COP26 and the climate crisis: How can plastic surgeons do their bit?

Berker, Henry T de; Bedford, James D

doi:10.1016/j.bjps.2021.11.048

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…37 Plastic surgeons, in particular, can be thought leaders in adopting climate-smart actions to improve the sustainability of surgical activities. 6,38 CONCLUSIONS Plastic surgery remains a field of innovation where adherence to foundational principles continues to carry it forward. The onus falls on surgeons not only to provide effective healthcare services but also to do so responsibly in an efficient and equitable manner.…”

Section: Discussionmentioning

confidence: 99%

“…Future studies, in addition to determining the impact of right-sizing surgical trays, could expand the scope of assessment to adapt environmentally friendly strategies that may further reduce operating room waste 37 . Plastic surgeons, in particular, can be thought leaders in adopting climate-smart actions to improve the sustainability of surgical activities 6,38 …”

Section: Discussionmentioning

confidence: 99%

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Utilization Fraction of Reduction Mammoplasty Instrument Sets

et al. 2023

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Purpose: Healthcare spending will account for 20% of US gross domestic product by 2028. One strategy to address rising costs is evaluating the utilization fraction (UF) of surgical trays. Utilization fraction averages between 13% and 27% among surgical specialties, yet data from plastic surgery are lacking. Methods: This prospective observational study assessed UF of surgical instruments in all reduction mammoplasty performed at 2 sites in the same healthcare system over a 6-month period. Site 1 is a tertiary hospital and site 2, an outpatient surgical center. Utilization fraction was calculated as percent fraction of used, or if operating surgeons touched them, to opened instruments. A new surgical tray was created by removing instruments not used in 20% of cases. Reprocessing costs and savings were calculated using published reprocessing figures of $0.10 to $0.51 per instrument. Descriptive statistics and parametric variables reported as mean ± standard deviation. Unpaired Student t test was performed to determine statistical significance of findings ( P < 0.05). Results: Four plastic surgeons performed 37 procedures, 11 at site 1 and 26 at site 2. At site 1, 112 instruments are opened in one tray with 53 unique and 59 duplicates. At site 2, 155 instruments are opened in 2 trays with 58 unique, 20 shared, and 77 duplicates. Instrument user did not vary by site ( P = 0.446), with 19 ± 3 instruments and 17 ± 3 instruments used per case; however, UF varied significantly ( P < 0.0001) with average UF of 16.6% ± 2.8% and 11.5% ± 1.7% at sites 1 and 2, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utilization Fraction of Reduction Mammoplasty Instrument Sets

et al. 2023

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“…PubMed was queried January 2022 using the terms “plastic surgery AND climate change.” Three potentially relevant articles were identified. 12 , 14 , 15 The paucity of literature in this area would not have supported a systematic or scoping review on the topic. A narrative review aiming to contextualize plastic and reconstructive surgery in climate change was therefore pursued.…”

Section: Methodsmentioning

confidence: 99%

A Narrative Review of Plastic Surgery and Climate Change: Context and Considerations

Hyland

Yates

Broyles

2022

Plastic and Reconstructive Surgery - Global Open

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Climate change poses significant threats to human health and society. Although healthcare will bear a large burden of the downstream effects of climate change, the healthcare industry is simultaneously a major contributor to climate change. Within hospitals, surgery is one of the most energy-intensive practices. There is a growing body of literature describing ways to mitigate and adapt to climate change in surgery. However, there is a need to better understand the unique implications for each surgical subspecialty. This review contextualizes plastic and reconstructive surgery within the climate change discussion. In particular, this review highlights the specific ways in which plastic surgery may affect climate change and how climate change may affect plastic surgery. In light of growing public demand for change and greater alignment between industries and nations with regard to climate change solutions, we also offer a conceptual framework to guide further work in this burgeoning field of research.

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Wide-Awake Hand Trauma Surgery: Designing Strategies to Optimise Patient Experience

Elzagh,

Shah,

De Berker

et al. 2024

Cureus

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Introduction: The regional hand trauma service in Greater Manchester, United Kingdom, underwent significant reorganisation early in the COVID-19 pandemic, with a shift from predominantly general anaesthesia (GA) procedures to the adoption of a Wide-Awake Local Anaesthetic No Tourniquet (WALANT) technique. We implemented strategies targeted towards optimising patient experience, largely applicable to most healthcare settings. Methods: Four domains were explored: (i) compliance in timing to nationally agreed treatment guidelines, (ii) the role of patient information leaflets, (iii) the introduction of a post-operative analgesia protocol, and (iv) broadly evaluating the environmental impact following the implementation of a same-day 'see and treat’ service. Results: Following reorganisation to a predominantly WALANT service, we observed an increase in compliance with nationally agreed standards for the treatment of common hand injuries. Patient education and peri-operative counselling reduced anxiety, whereas post-operative pain was better managed with the introduction of an analgesic protocol. Using a travel carbon calculator, it can be inferred that there are significant reductions in carbon emissions generated when patients are evaluated and treated on the same day as their clinical presentation. Conclusions: It is widely acknowledged that WALANT benefits patients and the healthcare system. We contemplated whether further incremental changes in clinical practice could further improve patient experience. Given our findings, we advocate a multi-modal approach with a greater focus on patient outcomes (trials are currently underway, e.g., WAFER) supplemented by universally accepted validated patient-reported outcome measures (PROMs).

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COP26 and the climate crisis: How can plastic surgeons do their bit?

Cited by 3 publications

References 5 publications

Utilization Fraction of Reduction Mammoplasty Instrument Sets

Utilization Fraction of Reduction Mammoplasty Instrument Sets

A Narrative Review of Plastic Surgery and Climate Change: Context and Considerations

Wide-Awake Hand Trauma Surgery: Designing Strategies to Optimise Patient Experience

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