General Surgery (inc. Breast Surgery)
How Is Climate Change Affecting Surgical Care?
General surgery is a surgical specialty that focuses on gastrointestinal tract, breast, kidney, pancreas and liver. Climate change can have an adverse effect on surgical care delivery and outcomes.
Although there are few studies directly linking climate change to surgical outcomes, warmer temperatures have been linked to an increased risk of surgical site infections. Every 1 °C rise in ambient temperature is predicted to increase risk of surgical site infections by 1 %, and the risk of superficial wound infections caused by gram negative pathogens.
Air pollution is recognized as a risk factor for lung cancer. There is also an increasing body of literature tying environmental pollution to the development of other cancers, such as breast and bladder cancer. Surgery is often an important aspect of cancer treatment and subsequent possible increases due the scale of environmental pollution we are seeing could greatly increase demand on the surgical workforce.
General surgeons work as part of a trauma team alongside with vascular surgeons and trauma and orthopaedic surgeons. Extreme weather events, such as wildfires, floods, storms and droughts, all come with risks of causing severe injuries that require surgery, raising the demand for trauma services and surgical intervention.
How is Surgical Care Affecting Climate Change?
Healthcare overall is responsible for 5-10% of global emissions, with surgery being the most environmentally impactful part of medicine. Operating rooms consume more energy than other hospital rooms, and vascular surgeons require even more energy in specially designed ‘hybrid’ theatre rooms.
Surgery generates approximately 25% of all hospital waste, much of which comes from single-use items or hazardous materials that require significant energy for proper disposal. In addition to energy, surgery demands large volumes of water for cleaning surgical instruments.
Anaesthetic gases and volatile agents, essential for many operations, directly pollute the atmosphere as they are released from patients' lungs. Halogenated anaesthetic gases, such as desflurane and nitrous oxide, are significant contributors to climate change. There are alternatives to these gases which can be used, and local or regional anaesthesia may be sufficient for many operations
Just how much waste is produced from a single operation? Find out below:
Green Surgery Report
The Royal College of Surgeons of England (RCSEng) have produced a comprehensive guide, known as the Green Surgery Report, to making surgical care more sustainable. Click below to find out more:
Discussion Ideas with Patients and Colleagues
Patients:
"Pre-habilitation is important before an operation to make your recovery easier. Sustainable ways of enhancing your recovery include walking and cycling rather than driving."
"Have you considered adopting a plant-based diet? It can help with your pre-habilitation to help you have a faster recovery after the operation, and can improve your health generally too."
Colleagues
"Has your unit signed the royal colleges Intercollegiate Green Theatre Checklist?"
"Have you ever thought what is the best way to reduce our carbon foot when operating, how about developing a green protocol for operations?
"How can we balance the need for single-use items in surgery for patient safety with the environmental impact of the waste they produce? Are there viable alternatives?"
Plant-Based Health Professionals UK have excellent resources on adopting a plant-based diet to improve health outcomes and have environmental benefits too.
Highest Impact Actions for Surgical Departments
Embed healthcare sustainability and climate change in all educational ad governance activities.
Empower your patients during the pre-habilitation and rehabilitation process, promoting active travel and plant-based diets.
Adopt the Green Theatre Checklist (see below) and recommendations from the Green Surgery Report
The Green Theatre Checklist
The UK and Irish surgical colleges have come together to produce a comprehensive evidence based checklist to make surgery as sustainable as possible. Get your department involved to play its part!
For More Information
Visit the Royal College of Surgeons of Edinburgh (RCSEd) sustainability pages for more ideas.