FP8.10 - Sustainability in Hand Surgery

Abstract Aims Carpal tunnel release surgery (CTR) is a widely performed procedure in the NHS with significant contributions to waste and carbon emissions within surgery. 36,704 CTRs were preformed from 2022-2023 with an average carbon footprint of 12.0 kg CO2e. The aim of this quality improvement project is to reduce the carbon footprint of CTR through a lean and green model, and examine the rates of infection with this model compared to standard practice. Methods Retrospective data was collected for CTRs performed at the Royal Cornwall Hospital between 31/05/2022 and 01/02/2023 for the first audit cycle using standard set up and equipment. The primary outcome was rates of infection post-CTR. The lean and green model included reducing the number of instruments in the handset (36 items to 14 items), use of a smaller drape, and no gown for the procedure. The second cycle will be examining rates of infection following this intervention. Results Out of 100 patients in the first cycle, 1 patient was treated with antibiotics via a General Practitioner telephone consultation. These eco-changes were well received by staff members, with significant waste reduction this far (over 50 gowns and 25 aperture drapes). Data collection for the second cycle is currently underway. Conclusions CTR surgery is a commonly performed procedure with significant contributions to waste and carbon footprint within surgery. Through simple and low-cost changes to current practice we can promote sustainability in surgery and have a lasting positive impact on the environment.