Reducing the carbon footprint of hand trauma surgery under local anaesthetic.

J Hand Surg Eur Vol · Aug 29 2026 · Recent

Kiely A, Macdonald K, Lees V

Department of Plastic Surgery, Wythenshawe Hospital, Manchester Foundation Trust, UK

Hand & Upper Extremity

SUMMARY — THE REDUCTIONUsing smaller drapes and streamlined instrument trays for minor hand trauma surgery cut carbon emissions and costs by up to 71% and 40% without increasing infection rates.
Abstract, as published

INTRODUCTION: This study measured how much the carbon footprint and hospital costs could be reduced by using fewer surgical instruments and drapes in minor hand trauma surgery.

METHODS: A retrospective cohort study of patients undergoing minor hand trauma procedures was carried out to compare carbon emissions between standard care and a reduced-waste protocol over a 4 month period. The size of drapes and instrument trays were reduced in the new protocol, having been identified as the most modifiable contributors to carbon footprint. Carbon emissions analysis and data on procedural costs and infection rates were collected and compared between the two models.

RESULTS: One-hundred patients were eligible for inclusion. Overall, 236 kg of carbon emissions were saved in the reduced waste group in the study period. Smaller drapes reduced CO2 emissions per procedure by 71%, and streamlined trays achieved a 20% reduction. Projected over 1 year, these changes were equated to a carbon saving comparable to planting 100 trees. Mean cost savings of 40% per procedure were achieved in the intervention group. There was no observed compromise in safety or infection rates in routine follow up.

CONCLUSIONS: Surgical services must take steps to reduce their environmental impact. This study provides a framework for other surgical specialties to implement climate safe practices. It demonstrates that practical, low-cost changes can yield significant environmental and financial benefits without compromising patient safety.

LEVEL OF EVIDENCE: III.

Featured in the 2026-08-31 issue.

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