Objectives: To agree on the 'top 10' research priorities for environmentally sustainable perioperative practice.
Design: Surveys and literature review; final consensus workshop using a nominal group technique.
Setting: UK-based setting.
Participants: Healthcare professionals, patients, carers and the public.
Outcome Measures: Initial survey-suggested research questions; interim survey-shortlist of 'indicative' questions (the 20 most frequently nominated by patients, carers and the public, and healthcare professionals); final workshop-ranked research priorities.
Results: Initial survey-1926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey-325 respondents. Final workshop-21 participants agreed the 'top 10': (1) How can more sustainable reusable equipment safely be used during and around the time of an operation? (2) How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation? (3) How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice? (4) Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations? (5) How can the amount of waste generated during and around the time of an operation be minimised? (6) How do we measure and compare the short-term and long-term environmental impacts of surgical and non-surgical treatments for the same condition? (7) What is the environmental impact of different anaesthetic techniques (eg, different types of general, regional and local anaesthesia) used for the same operation? (8) How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs? (9) How can environmental sustainability be incorporated into the organisational management of operating theatres? (10) What are the most sustainable forms of effective infection prevention and control used around the time of an operation (eg, personal protective equipment, drapes, clean air ventilation)?
Conclusions: A broad range of 'end-users' have identified research priorities for sustainable perioperative care.
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http://dx.doi.org/10.1136/bmjopen-2022-066622 | DOI Listing |
BMC Surg
January 2025
Global Surgery Division, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Climate change is an emerging global health crisis, disproportionately affecting low- and middle-income countries (LMICs) where health outcomes are increasingly compromised by environmental stressors such as pollution, natural disasters, and human migration. With a focus on promoting health equity, Global Surgery advocates for expanding access to surgical care and enhancing health outcomes, particularly in resource-limited and disaster-affected areas like LMICs. The healthcare industry-and more specifically, surgical care-significantly contributes to the global carbon footprint, primarily through resource-intensive settings, i.
View Article and Find Full Text PDFInjury
January 2025
Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, India.
Background: Falls are some of the most common childhood injuries. However, for vulnerable children in low- and middle-income countries (LMICs) such as India, mortality from a fall is nearly three times that of high-income countries. Despite fall being a leading cause of paediatric injury, detailed data from LMICs remain sparse.
View Article and Find Full Text PDFANZ J Surg
January 2025
Bariatric Surgery Registry, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Background: To determine if the positive outcomes from clinical trials regarding the safety and efficacy of metabolic bariatric surgery are reproducible at a national level.
Methods: A longitudinal registry-based observation study with data collected from all persons undergoing metabolic bariatric surgery in Australia from 28 February 2012-31 December 2021 including data from 122,567 index patients who underwent 134,625 completed bariatric procedures.
Main Outcomes And Measures: Defined adverse outcomes at 90-days (unplanned readmission, intensive care admission and re-operation; death), annual change in weight (percent total body weight loss (TBWL)), diabetes treatment and need for re-operation.
BMJ Open Qual
January 2025
Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Transfusion of blood products following cardiothoracic surgery represents a significant proportion of national blood product usage, has significant cost implications and is associated with increased 30-day mortality. Following identification of an increase in blood product use, we implemented a healthcare improvement initiative using a perioperative care model and establishment of a new multispecialty cardiothoracic surgery taskforce to further define and tackle the problem. The initiative incorporated a bundle of preoperative identification of high-risk patients, an intraoperative haemostasis checklist, a programme of unit education focussing on bleeding postbypass and use of thromboelastography and introduction of postoperative protocols for identification and escalation of bleeding.
View Article and Find Full Text PDFJ Heart Lung Transplant
January 2025
Division of Cardiac Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA. Electronic address:
Objective: Genetically engineered porcine hearts may have an application for infants in need of a bridge to cardiac allotransplantation. The current animal model that resulted in 2 human applications has been validated in adult non-human primates only. We sought to create an infant animal model of life sustaining cardiac xenotransplantation to understand limitations specific to this age group.
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