非黑色素瘤皮肤癌手术的碳足迹
Carbon footprint of non-melanoma skin cancer surgery
影响因子:4.50000
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
摘要
气候变化构成了包括手术在内的重要全球健康威胁和医疗保健，这有助于温室气体排放。已经为促进手术的可持续性做出了努力，但是有关整形外科可持续性的文献仍然有限。生命周期分析用于评估和量化与非黑色甲状腺瘤皮肤癌手术中使用的三种不同的重建方法相关的环境排放：直接闭合，分裂性的皮肤嫁接和全颗粒型皮肤。分析于2023年3月在英国斯旺西的莫里斯顿医院进行。然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量为29.82至34.31kgco₂eq。剧院能源消耗（4.29-8.76kgco₂eq）和消耗品（16.87kgco₂eq）是重要的贡献者。在非黑色素瘤皮肤癌手术期间产生的废物占1.31kgco₂eq，可重复使用的手术仪器的灭菌导致1.92kgco₂eq的碳排放。同时，运输，敷料，药品和洗衣店分别占0.57、2.65、1.85和0.38kgco₂eq。直接闭合（19.29-22.41kgco₂eq）切除非黑色素瘤皮肤癌的切除导致碳排放量最低，而切除术则具有分裂的皮肤移植物（43.80-49.06kgco₂eq）和全厚度的皮肤移植物（31.58-37.02 kgcococco）。据估计，在2021年，威尔士的非黑色素瘤皮肤癌手术的年碳足迹为306 775kgco₂eq，在英格兰为4 402 650kgco₂eq。可以预测，到2035年，非黑色素瘤皮肤癌手术的碳排放量将占威尔士的388 927kgco₂eq，在英格兰占5 419 770kgco₂q。这项研究突出了整形外科部门在整形外科癌症中的环境影响。外科医生和决策者之间的协作至关重要，建议进一步的数据收集以进行更好的分析。
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.