{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:34:42Z","timestamp":1792971282878,"version":"4.5.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"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":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"\n Introduction:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n 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\u2009month 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.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n One-hundred patients were eligible for inclusion. Overall, 236\u2009kg of carbon emissions were saved in the reduced waste group in the study period. Smaller drapes reduced CO\n 2<\/jats:sub>\n emissions per procedure by 71%, and streamlined trays achieved a 20% reduction. Projected over 1\u2009year, 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.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Level of evidence:<\/jats:title>\n III<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/17531934261468591","type":"journal-article","created":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T03:13:21Z","timestamp":1788059601000},"page":"1357-1362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing the carbon footprint of hand trauma surgery under local anaesthetic"],"prefix":"10.1177","volume":"51","author":[{"given":"Ailbhe","family":"Kiely","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Wythenshawe Hospital, Manchester Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6040-7644","authenticated-orcid":false,"given":"Katherine","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Wythenshawe Hospital, Manchester Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien","family":"Lees","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Wythenshawe Hospital, Manchester Foundation Trust, Manchester, UK"},{"name":"Division of Cell Matrix Biology and Regenerative Medicine, University of Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"British Society for Surgery of the Hand. Hand surgery in the UK. A resource for those involved in organising delivering and developing services for patients with conditions of the hand and wrist 2018. https:\/\/www.bssh.ac.uk\/_userfiles\/pages\/files\/professionals\/Handbook\/Hand%20Surgery%20in%20the%20UK_2021Edit.pdf (10th June 2025)."},{"key":"e_1_3_3_3_1","unstructured":"Centre for Sustainable Healthcare. Sustainability in quality improvement 2022. https:\/\/www.susqi.org\/ (25th May 2025)."},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2014.12.014"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/17531934231176952"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resconrec.2020.104704"},{"key":"e_1_3_3_7_1","unstructured":"National Institute for Health and Care Excellence. Surgical site infections: prevention and treatment. London NICE 2020. https:\/\/www.nice.org.uk\/guidance\/ng125\/chapter\/Context (28th August 2025)."},{"key":"e_1_3_3_8_1","unstructured":"NHS England. Delivering a \u2018net zero\u2019 national health service 2022. https:\/\/www.england.nhs.uk\/greenernhs\/publication\/delivering-a-net-zero-national-health-service\/ (20th May 2025)."},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/24730114241238231"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/01410768231166135"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003951"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717743595"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304397"},{"key":"e_1_3_3_14_1","unstructured":"UK Government. Greenhouse gas reporting: conversion factors 2025. 2025. https:\/\/www.gov.uk\/government\/publications\/greenhouse-gas-reporting-conversion-factors-2025 (18th July 2025)."},{"key":"e_1_3_3_15_1","unstructured":"UK Government. Health and Care Act. 2022. https:\/\/www.legislation.gov.uk\/ukpga\/2022\/31\/contents (20th May 2025)."},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_3_3_17_1","unstructured":"World Health Organization. Press release. Climate change is bad for health but climate services save lives 2023. https:\/\/wmo.int\/news\/media-centre\/climate-change-bad-health-climate-services-save-lives (28th August 2025)."}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261468591","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934261468591","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261468591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:00:58Z","timestamp":1792969258000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934261468591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,29]]},"references-count":16,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/17531934261468591"],"URL":"https:\/\/doi.org\/10.1177\/17531934261468591","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,29]]}}}