45 Skin Preparation in Arthroscopic Surgery – Are There Environmental Savings to Be Made?

Background The environmental impact of surgery is concern that has been raised in recent years. Operating theatres have been found to create up to 230kg of waste per day. There is a need to reduce surgical waste whilst maintaining patient safety. This study assessed the waste and CO2 production associated with two accepted skin preparation techniques. Method Groups consisted of two consultant surgeons, both performing 5 arthroscopic procedures. Surgical skin preparation was performed with disposable ChloraPrep™ sticks or bottled Hydrex 0.5% solution with red dye. Annual waste and CO2 production was assessed via modelling. Results The disposable group generated a total of 876g of net waste compared to 1727g in the solution group. Waste per surgical case was 134.6g (SD 14.97) in the disposable group compared to 328.8g (SD 86.09) in the solution group. The disposable group produced significantly less waste than the solution group (P <0.0069). In 2022, a total of 514 arthroscopies were performed at our institution (134 shoulder, 380 knee). Modelling using the research group data provided estimated annual waste in both groups; 225.132kg in the ChloraPrep™ stick group compared to 443.839kg in the Hydrex 0.5% solution group, with Kg CO2 production of 241.79-701.57 Kg and 476.68-1383.13 Kg in each group respectively. Conclusions This study demonstrates that choice of skin preparation in arthroscopy can significantly reduce waste and CO2 production, without a significant increase in cost.