Waste management in hand surgery: a quantitative and qualitative analysis

Introduction: The healthcare sector accounts for 5–10 per cent of global carbon emissions with a significant contribution from operating theatres. This study aims to comprehend the carbon footprint of waste generated in hand surgery. Methods: Waste generated from 21 surgical procedures done both in operating theatres under general anaesthetic and procedural suites under local anaesthetic was segregated into clean paper, contaminated paper, clean plastic and contaminated plastic, and weighed before routine disposal. The waste management policy of the institution was examined to estimate the financial and emissions burdens. Results: This study found a mean of 1.922 kg of waste was generated per procedure. More complex procedures, such as open reduction and internal fixation, generated more waste (mean = 5.182 kg) compared to less complex procedures, such as incision and drainage of abscess, tendon repair or nail bed repair (mean = 1.382 kg). A mean reduction in total waste of 0.86 kg per procedure was achieved by performing eligible, less complex procedures in the procedural suite under local anaesthetic. This translated to an annual reduction of 0.77 tonnes of total surgical waste with a cost saving of NZ$376.70 for disposal and a reduction of 252 kgCO2e in carbon emissions. Conclusion: This study sheds light on the carbon footprint of waste generated from hand surgery. A collaborative effort is required to mitigate the deleterious impact of surgical waste on climate change. Judicious use of procedural suites is a simple strategy to reduce waste and carbon emissions.