{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:59:00Z","timestamp":1790117940793,"version":"4.0.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Operating rooms (ORs) produce approximately 70% of hospital waste. Greening strategies in the OR aim to reduce the environmental impact of surgery while maintaining patient safety and outcomes. The aim of this study was to strategically reduce waste and cost associated with common ambulatory hand procedures by implementing a 3-stage \u201cgreen case\u201d plan over a 1-year period in a high-volume tertiary referral hand surgery division.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A 3-stage greening initiative for hand surgery was designed and implemented in ambulatory open carpal tunnel release (CTR) and trigger finger release (TFR) cases, including: (1) introduction of minor field sterility; (2) implementation of a lean and green minor hand surgery pack and reduced instrument set; and (3) elimination of gown use by surgeons and OR staff. Surgical supply usage and costs were tracked during the study period and compared with control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Each \u201cgreen case\u201d resulted in savings of $105 compared with the control cases from the preceding year, excluding cost savings associated with reduced waste processing. There was a 64% and 75% reduction in waste and costs after greening, respectively. This equates to a minimum institutional annual savings of $51\u2009000 when used for CTR and TFR. There was no observed increase in surgical site infections or complications after the introduction of greening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Greening initiatives can be successfully implemented by surgeons to reduce waste and costs. With targeted greening of CTR and TFR procedures, we significantly reduced waste and decreased costs while maintaining patient safety and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447231220412","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T11:21:46Z","timestamp":1703935306000},"page":"634-641","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Greening Hand Surgery: Targeted Measures to Reduce Waste in Ambulatory Trigger Finger and Carpal Tunnel Decompression"],"prefix":"10.1177","volume":"20","author":[{"given":"Ruth","family":"Tevlin","sequence":"first","affiliation":[{"name":"Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-045X","authenticated-orcid":false,"given":"Jasmine A.","family":"Panton","sequence":"additional","affiliation":[{"name":"Dartmouth College, Hanover, NH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4166-8547","authenticated-orcid":false,"given":"Paige M.","family":"Fox","sequence":"additional","affiliation":[{"name":"Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.343."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.18481."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1610."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.0140."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/175045891302300605."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s43017-021-00223-2."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001932."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15598."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.01816."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.4172\/plastic-surgery.1000941."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2022.0032."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2017.11.007."},{"issue":"9","key":"e_1_3_3_14_2","first-page":"49","article-title":"Cost savings using minimal draping for routine hand procedures","volume":"97","author":"Sieber D","year":"2014","unstructured":"Sieber D, Lacey A, Fletcher J, et al. 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