Green operating theatres
Greening Operating Rooms in Europe (GREEN) study – the results of which were published in Annals of Medicine & Surgery.5 In this paper, Baker et al explained that fluid
surgical waste is typically collected in disposable plastic suction canisters and disposed of by two methods. Clinical staff either manually open the canisters and pour the contents down the drain, which poses a significant infection risk due to splashing or aerosolisation, or they open the container and add chemical solidifiers (or isolysers) to the contents. Once the solidifier has made the canister contents immoveable, the canister is then placed in the regulated medical waste stream for treatment and disposal, which also risks exposure to pathogens. The medical waste often ends up in incineration, which is further associated with significant impacts on the environment. The GREEN study set out to
compare Neptune (from Stryker) – a constantly closed waste management system that collects, transports and disposes of surgical waste fluid – versus canisters. The two-arm, non-randomised, prospective study collected data from routine urology and orthopaedic surgeries, across three European hospital sites, including Friarage Hospital (also within the South Tees Hospitals NHS Trust), Hospital Sant Pau, and Hospital Germans Trias. The primary endpoint of waste disposal impact was the volume of treated waste after surgery (kilograms) using Stryker’s Neptune device (n= 43) or canisters (n= 41). The authors hypothesised that the surgical waste volume related to Neptune is less than the waste volume related to canisters. Secondary endpoints included
One of the main benefits we saw immediately, before even starting the trial, was that Neptune is a closed system. This benefited our infection control procedures. Theatres previously had to manoeuvre bags of fluid, urine and blood, and despite using solidifying gel, it was still a difficult process. Sarah Baker, Operational Lead, Theatres.
time efficiency, user satisfaction, and staff ergonomics.
Results The total weight of device-related treated waste products was reduced by 98.5% when using Neptune compared with traditional canisters. The use of Neptune also reduced the total number of disposable device-related products used per procedure by 87.5%. Decreased waste weight also translated to enhanced ergonomic safety for surgical staff, as Neptune reduced surgical fluid weight, handled by staff, by an average of 34 kg per procedure - a 96% reduction compared to canisters. Furthermore, the use of
the Neptune system improved operating theatre efficiency by reducing the number of staff required to manage the fluid suction device and the time spent disposing of fluid waste. When considering intraoperative and postoperative time spent collecting and disposing fluid waste, the use of Neptune resulted in an 83.9% time saving (average mean difference of 11.5 min).
General satisfaction regarding the use of
surgical waste systems was rated by both surgeons and theatre nurses: 97.7% of nurses said they were very satisfied or satisfied with the set-up of Neptune, the emptying/ disposing of the waste from the system, the time efficiency, and its general performance. Additionally, 97.7% of nurse operating staff stated that the Neptune device use during surgery and overall safe use were both very easy or easy. In contrast, 63% of nurse operating staff were ‘very unsatisfied’ or ‘unsatisfied’ with the canister waste disposal process and over 46% said safe use of the canisters was ‘very difficult’ or ‘difficult’’. With regards to surgeons, 95.3% of operating
surgeons said they were very satisfied or satisfied with the use of Neptune in their working environment; 88.4% said they were very satisfied or satisfied with both the general performance of the device, as well as the performance of the suction during surgery.
Conclusions The researchers concluded that Stryker’s Neptune waste management system significantly reduces the volume of treated waste per surgery and improves theatre efficiency, staff safety, and user satisfaction, when compared to the traditional canister
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www.clinicalservicesjournal.com I December 2024
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