{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:07:07Z","timestamp":1785154027017,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To quantify cost, waste, carbon emissions and early feasibility of source reduction in proctology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Population\u2010based cost and carbon analysis of common proctology procedures in New South Wales public hospitals. Targeted recycling was compared with source reduction through drape avoidance, clean non\u2010sterile protective equipment, and selective opening of suction and diathermy. A focused audit assessed state\u2010level inputs against routine practice. Implementation outcomes followed adoption at one tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Annual procedures totalled 6753 in New South Wales. The Australian denominator was 22,084 procedures. Suction and diathermy were unused in 54% and 46% of audited procedures respectively. Targeted recycling was projected to save AUD 0.84 (GBP 0.44, EUR 0.52) and 0.47\u2009kg waste per procedure. Source reduction was projected to save AUD 40 (GBP 21.06, EUR 24.80), 1.36\u2009kg waste and 7.9\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e per procedure. For conservative national modelling using 20,000 cases, projected annual savings were AUD 776,857 (GBP 408,938, EUR 481,651), 27 tonnes waste and 158 tonnes CO\n                      <jats:sub>2<\/jats:sub>\n                      e. During early implementation, no infective complications were recorded in 100 procedures. Drape omission avoided a median 3\u2009min of set\u2010up time. Selective device opening introduced a 30\u2010s delay when required. Four of five surgeons adopted the practice, and 11 of 12 nurses strongly supported the source\u2010reduction initiative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Source reduction was feasible in early proctology implementation and projected to reduce cost, waste and carbon emissions. These proof\u2010of\u2010concept findings support multicentre evaluation but do not establish clinical equivalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70550","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T03:01:09Z","timestamp":1784084469000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ditch the drapes: Non\u2010sterile substitution in proctology, a population\u2010based cost and carbon life cycle analysis with early implementation audit"],"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":"Northern Clinical School, Sydney Medical School The University of Sydney  Sydney Australia"},{"name":"Department of Colorectal Surgery Royal North Shore Hospital  Sydney Australia"},{"name":"School of Clinical Medicine University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Russell","sequence":"additional","affiliation":[{"name":"Northern Sydney Local Health District  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Sung","sequence":"additional","affiliation":[{"name":"HealthShare NSW  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3826-3845","authenticated-orcid":false,"given":"Amit","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal North Shore Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Dickson","sequence":"additional","affiliation":[{"name":"Independent Researcher"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Morgan","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6357-3709","authenticated-orcid":false,"given":"Margaret","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Northern Clinical School, Sydney Medical School The University of Sydney  Sydney Australia"},{"name":"Department of Colorectal Surgery Royal North Shore Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(20)30121-2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(17)30162-6"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(17)30180-8"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.5814"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00314"},{"key":"e_1_2_12_7_1","article-title":"Use of plastic adhesive drapes during surgery for preventing surgical site infection","volume":"2015","author":"Webster J","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.02.002"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/aorn.12885"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.70532"},{"key":"e_1_2_12_11_1","unstructured":"Australian Government.Medicare Statistics [Medicare Item Reports]. 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