189 Environmental and Financial Benefits of Extended Chest Drain Bottle Use in Ivor Lewis Gastroesophagectomy (ILGO) Patients

Abstract Aim Medical waste contributes 5–10% of plastic waste. Chest drain (CD) bottles are single-use items, typically changed daily, exacerbating this problem. Each CD bottle in our unit generates 2.53 kg of CO₂e (production, transport, disposal). With simple nursing education, we changed the protocol from daily CD bottle changes to changing only when the bottle is full (1800 ml) or when drainage colour changes. Method This QI project included a retrospective (July 2023–October 2023) analysis of post-ILGO patients. Patients with abandoned procedures or CD bottle changes in ITU were excluded. Post-intervention, a prospective analysis (December 2023–April 2024) was undertaken. Data included length of stay, total CD bottles, carbon emissions, and financial savings. Results 20 patients were included in each cycle. First cycle, 185 CD bottles (median 7) were used during a median stay of 7 days, generating 468.93 kg of CO₂e and costing £1,424.50. Post-intervention, 47 CD bottles (median 2) were used during a median stay of 8 days, generating 119.13 kg of CO₂e and costing £361.90. This represented a 74.6% reduction in cost and carbon emissions. No complications related to extended CD bottle use were recorded. By reducing the frequency of bottle changes, this practice offered undocumented financial savings through reduced nursing time and risk of complications from human errors, such as CD malposition, clamped CD, or missed water seal. Conclusions Extended CD bottle use post-ILGO is safe, cost-effective, and supports NHS sustainability goals. Our unit now saves 11.11 kg CO₂e and £38.50 per post-ILGO patient.