Operating Room Waste Reduction In Plastic and Hand Surgery, A Cost-Analysis

Background: Operating rooms, combined with labor and delivery suites, account for approximately 70% of hospital waste. OR waste reduction is the most effective method of initiating green practices in the surgical setting. Cost-saving initiatives have popularized the concept of reprocessing single-use devices. However, studies have shown that these reprocessed instruments are not disinfected and sterilized properly, thus exposing patients to bacteria and viruses. We propose a method of decreasing cost by avoiding the waste of single-use devices altogether, through judicious selection of instruments and supplies used in plastic and hand surgery.

Methods: The authors examined the current sets of disposable items and instruments designated for common plastic and hand surgery procedures at one of the three teaching hospitals affiliated with our institution. We identified the supplies and instruments that are routinely opened and wasted. We then selected only those items that are usually used during these cases, and calculated the savings that can result from eliminating extraneous items.

Results: The total cost of the plastic and hand surgery packs currently being used for all cases is $106.64 and $49.36, respectively. We propose removing 15 total items from the plastic pack and 7 total items from the hand pack. This saves $12.85 (12.0% savings) per plastic surgery pack, and $4.80 (9.7% savings) per hand surgery pack. For the estimated 613 plastic surgery cases and 1,980 hand surgery cases performed at this outpatient hospital, a total of $17,381.05 could be saved per year from these changes alone. Our redesigned plastic and hand instrument sets reduced the number of instruments by 41 and 34, respectively. These changes are potentially cost-saving through reductions in autoclaving, labor, and turnover time. 

Conclusions: OR waste reduction is an effective method of cutting cost in the surgical setting. By revising the contents of current disposable packs and instrument sets designated for plastic and hand surgery, hospitals can reduce the amount of opened and unused material. Significant savings can result from this judicious selection of supplies and instruments. If this simple cost-saving measure is employed in all types of surgery at a given hospital, greater savings are possible. Additionally, implementation of this approach at all hospitals could result in significant savings at the national level.