Introduction:
The Royal College of Australasian College of Surgeons (RACS) has issued a statement on the need to recognise the environmental impact of surgical practice in 2018 with operating theatre being one of the key sources of waste production. We would like to investigate the estimated yearly carbon waste of our operating theatres for a Level 1 tertiary New Zealand Plastic Surgery unit.
Methods:
Three scenarios were used in this study to reflect common surgical procedures being undertaken for trauma and elective settings in our department:
A. Excision of a skin lesion in a local anaesthetic (LA) procedure with direct closure over 1 hour
B. Debridement and closure of a wound under general anaesthetic (GA) for 1 hour
C. Incision and direct closure of an elective procedure under GA for 2 hours.
A standard proforma was used to collect the data on country of origin of each material used for all three scenarios. The carbon footprint of each scenario was calculated with Certified Carbon Ltd software and New Zealand 2022 measuring emission guidance with extrapolation for annual estimation.
Results:
The carbon footprint for all three scenarios is calculated as follows:
A. 1.64 kgCO2-e B. 2.22 kgCO2-e C. 5.75 kgCO2-e.
A typical day consisting of 7 procedures in our skin cancer LA list will generate 15.54 kgCO2-e from disposed materials and energy. Annually this is equivalent to 564 tonne CO2.
Our department alone is projected to produce 1845 tonne CO2 a year from theatre activity, which is comparable to 20000 hours of a single commercial aviation flight.
Conclusion:
Operating theatre has a huge carbon waste and possible strategies based on the 5 Rs (reduce, recycle, reuse, rethink and research) as described in RACS 2018 statement should be considered to address this.