{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:37:46Z","timestamp":1784122666439,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Proctology is a useful test case for low\u2010waste surgery because the central premise of routine sterile set\u2010up is contestable. These procedures are common, short and material intensive, but they are performed at a mucocutaneous site that cannot be rendered sterile. The distal gut contains thousands of bacterial species, with one third of them potential pathogens. Antiseptic preparation reduces this burden, but does not eliminate it. In this context, the relevant question is not whether every opened sterile item can be recycled, but whether it needed to be opened at all. This article argues for a disciplined, indication\u2010based approach to benign anorectal surgery. Instrument sterility, aseptic handling, skin preparation, sharps safety and antibiotic prophylaxis should remain unchanged. The proposed change is narrower: avoid routine drapes where they do not alter the operation, use clean non\u2010sterile protective equipment for proceduralists where appropriate, and keep suction and diathermy immediately available but unopened until required. Infection prevention objections deserve respect, and selected cases will still require conventional sterile set\u2010up. However, routine sterile consumables should not be defended by habit when the field itself is already contaminated. Proctology should lead a simple hierarchy: use less, open on demand and recycle only where true material recovery is available.<\/jats:p>","DOI":"10.1111\/codi.70532","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:41:51Z","timestamp":1781844111000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use less, waste less: Rethinking consumable use in proctology"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6491-4993","authenticated-orcid":false,"given":"Matthew P.","family":"Irwin","sequence":"first","affiliation":[{"name":"School of Medicine The University of Sydney  Sydney Australia"},{"name":"School of Clinical Medicine University of new South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41522-024-00580-y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.02029"},{"issue":"4","key":"e_1_2_7_4_1","first-page":"8883","article-title":"Procedural povidone iodine rectal preparation reduces bacteriuria and bacteremia following prostate needle biopsy","volume":"24","author":"Allen J\u2010L","year":"2017","journal-title":"Can J Urol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-021-02422-x"},{"key":"e_1_2_7_6_1","article-title":"Use of plastic adhesive drapes during surgery for preventing surgical site infection","volume":"4","author":"Webster J","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.5814"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00314"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(20)30121-2"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(17)30162-6"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000006085"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2008.0311"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wasman.2017.07.044"},{"key":"e_1_2_7_14_1","unstructured":"IrwinMP RussellD SungI Sarkar A Kabir S Schnitzler M.Ditch the Drapes: Achieving Sutainable Surgery in Proctology.20258th International Conference on Environmental Sustainability and Climate Change; 16\u201317 June; Rome Italy2025."},{"key":"e_1_2_7_15_1","unstructured":"IrwinMP RussellD SungI Sarkar A Kabir S Schnitzler M.\u2018Ditch the drapes\u2019 and other evidence\u2010based measures to improve sustainability in proctology.2025European Society of Coloproctology 20th Scientific Conference; 10\u201312 June; Paris France2025."},{"key":"e_1_2_7_16_1","unstructured":"IrwinMP RussellD SungI Sarkar A Zhou X Schnitzler M.Sterility Theatre: Ditching Drapes Cuts Cost and Carbon in Proctology.202694th Royal Australasian College of Surgeons Annual Scientific Congress; 1\u20133 May; Perth Australia2026."},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1568145"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70532","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.70532","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70532","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:25:41Z","timestamp":1782451541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/codi.70532"],"URL":"https:\/\/doi.org\/10.1111\/codi.70532","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70532"}}