非黑色素瘤皮肤癌手术的碳足迹

Carbon footprint of non-melanoma skin cancer surgery

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BJS Open

影响因子:4.5

分区:医学3区 / 外科3区

发表日期:2024 Sep 03

作者: Ky-Leigh Ang, Matthew Jovic, Ian Malin, Stephen R Ali, Sairan Whitaker, Iain S Whitaker

DOI: 10.1093/bjsopen/zrae084

摘要

气候变化构成了重大的全球健康威胁，医疗保健，包括手术，亦对温室气体排放产生贡献。虽然已采取措施促进手术的可持续性，但关于整形外科领域的可持续性文献仍然有限。本研究采用生命周期分析，评估并量化非黑色素瘤皮肤癌手术中使用的三种不同重建方法的环境排放：直接缝合、分层皮肤移植和全层皮肤移植。分析于2023年3月在英国斯旺西Morriston医院进行，随后估算了英格兰和威尔士非黑色素瘤皮肤癌手术的碳足迹。非黑色素瘤皮肤癌手术的平均碳排放范围为29.82至34.31 kgCO₂当量（kgCO₂eq）。手术室能源消耗（4.29-8.76 kgCO₂eq）和耗材（16.87 kgCO₂eq）是主要贡献者。手术中产生的废物排放为1.31 kgCO₂eq，重复使用手术器械的灭菌过程产生1.92 kgCO₂eq的碳排放。运输、敷料、药品和洗衣的排放量分别为0.57、2.65、1.85和0.38 kgCO₂eq。采用直接缝合切除非黑色素瘤皮肤癌（19.29-22.41 kgCO₂eq）导致的碳排放最低，而分层皮肤移植（43.80-49.06 kgCO₂eq）和全层皮肤移植（31.58-37.02 kgCO₂eq）则更高。2021年估算，威尔士的非黑色素瘤皮肤癌手术年碳足迹为306,775 kgCO₂eq，英格兰为4,402,650 kgCO₂eq。预测到2035年，非黑色素瘤皮肤癌手术的碳排放在威尔士将达到388,927 kgCO₂eq，在英格兰则达5,419,770 kgCO₂eq。本研究强调了非黑色素瘤皮肤癌在整形外科部门的环境影响，并强调了实施可持续实践的必要性。外科医生与政策制定者的合作至关重要，建议进一步收集数据以进行更深入的分析。

Abstract

Climate change poses a significant global health threat and healthcare, including surgery, contributes to greenhouse gas emissions. Efforts have been made to promote sustainability in surgery, but the literature on sustainability in plastic surgery remains limited.A life-cycle analysis was used to assess and quantify the environmental emissions associated with three distinct reconstructive methods utilized in non-melanoma skin cancer surgery: direct closure, split-thickness skin graft, and full-thickness skin graft. Analyses were conducted in March 2023 in Morriston Hospital, Swansea, UK. The carbon footprints for non-melanoma skin cancer surgery in England and Wales were then estimated.The mean carbon emissions for non-melanoma skin cancer surgery ranged from 29.82 to 34.31 kgCO₂eq. Theatre energy consumption (4.29-8.76 kgCO₂eq) and consumables (16.87 kgCO₂eq) were significant contributors. Waste produced during non-melanoma skin cancer surgery accounted for 1.31 kgCO₂eq and sterilization of reusable surgical instruments resulted in 1.92 kgCO₂eq of carbon emissions. Meanwhile, transportation, dressings, pharmaceuticals, and laundry accounted for 0.57, 2.65, 1.85, and 0.38 kgCO₂eq respectively. The excision of non-melanoma skin cancer with direct closure (19.29-22.41 kgCO₂eq) resulted in the lowest carbon emissions compared with excision with split-thickness skin graft (43.80-49.06 kgCO₂eq) and full-thickness skin graft (31.58-37.02 kgCO₂eq). In 2021, it was estimated that non-melanoma skin cancer surgery had an annual carbon footprint of 306 775 kgCO₂eq in Wales and 4 402 650 kgCO₂eq in England. It was possible to predict that, by 2035, carbon emissions from non-melanoma skin cancer surgery will account for 388 927 kgCO₂eq in Wales and 5 419 770 kgCO₂eq in England.This study highlights the environmental impact of non-melanoma skin cancer in plastic surgery departments and emphasizes the need for sustainable practices. Collaboration between surgeons and policymakers is essential and further data collection is recommended for better analysis.