Packaging waste in the operating room

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Climate change is acentral issue for our future. The increase in the amount of greenhouse gases in the atmosphere promotes the so-called greenhouse effect, resulting in climate change. Worldwide, the amount of plastic waste amounts to approximately 8billion tons. The healthcare sector is responsible for around 4.4% of global net emissions contributing to the greenhouse effect. Measures to reduce CO2emissions within the healthcare sector should be implemented accordingly. To make the issue of plastic waste in the operational sector more visible, in the present study we examined and calculated the packaging waste generated in the treatment of distal radius fractures. The clinic stocks two different implants (sterile packaging = groupI vs. implant tray = groupII) for the treatment of distal radius fractures. Over aperiod of 12months (July 2022-July 2023), the packaging waste from all surgically treated distal radius fractures was collected and weighed. The time required to retrieve, unpack and provide the implants in both groups (referred to as preparation time) was measured. Patient data were recorded in adedicated register and statistical significances were calculated. Atotal of 124 distal radius fractures were treated. The average age of the cohort was 67.9 years with 74.2% being female. The system with sterile individual packaging (groupI) was used for fracture treatment 29times, while the system with the screw tray (groupII) was used 94times. For treatment with sterile packaging 104.5g of plastic waste and 67.4g of plastic-free packaging waste were generated per operation, while treatment with the implant tray resulted in 21.6g of plastic waste and 12.8g of plastic-free packaging waste (p = 0.0001). The average time for providing the screws in groupIwas significantly higher at 527.8 s compared to treatment with the implant tray in groupII at 138 s (p = 0.0001). In the present study we found asignificant increase in plastic waste when using individually packaged implants. To reduce the production of plastic waste, mandatory guidelines for waste separation in the operating room appear to be sensible. Measures such as the return and recycling of recyclable plastic waste as well as improvements in packaging design and the use of bio-based biodegradable and compostable plastics, represent further possibilities for waste reduction.