Comparison of Costs and Energy Expenditure in Common Hand Surgery: Operating Theatre Versus Ward Procedure Room

The health care sector is the fifth largest contributor to greenhouse emissions globally. Results of several studies have demonstrated that altering surgical practices from inpatient to outpatient service was associated with cost savings, reduction of medical waste and energy expenditure. The objective of this study was a comparison of costs and energy expenditure for hand surgeries performed in an operating theatre versus a ward procedure room. The analysis included the cost of materials, cost of sterilization of surgical instruments and energy expenditure for sterilization generated at standard hand surgery operations, including carpal tunnel release, surgery for Dupuytren's disease, benign tumor and ganglion cyst excision, de Quervain's disease, or trigger finger release. Typical hand surgery operations performed in a procedure room at the surgical ward generated lower costs (amounting to 53% of main theatre costs), 1 kg less clinical waste and were associated with significant (67%) reduction in energy expenditure compared to surgeries performed in the main operative theatre. Performing common hand surgery operations in a ward procedure room instead of the operating theatre resulted in significant economic and environmental benefits without compromising patient safety.