{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:56:58Z","timestamp":1790017018277,"version":"4.0.1"},"reference-count":13,"publisher":"Universa BV","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Introduction. The health care sector is the fifth largest contributor to greenhouse emissions globally. Results of several studies have demonstrated that altering surgical practices from inpatient to outpatient service was associated with cost savings, reduction of medical waste and energy expenditure. The objective of this study was a comparison of costs and energy expenditure for hand surgeries performed in an operating theatre versus a ward procedure room. The analysis included the cost of materials, cost of sterilization of surgical instruments and energy expenditure for sterilization generated at standard hand surgery operations, including carpal tunnel release, surgery for Dupuytren\u2019s disease, benign tumor and ganglion cyst excision, de Quervain\u2019s disease, or trigger finger release. Typical hand surgery operations performed in a procedure room at the surgical ward generated lower costs (amounting to 53% of main theatre costs), 1 kg less clinical waste and were associated with significant (67%) reduction in energy expenditure compared to surgeries performed in the main operative theatre.\n\nPerforming common hand surgery operations in a ward procedure room instead of the operating theatre resulted in significant economic and environmental benefits without compromising patient safety.<\/jats:p>","DOI":"10.52628\/91.1.041026","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:46:52Z","timestamp":1755107212000},"page":"71-76","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Costs and Energy Expenditure in Common Hand Surgery: Operating Theatre Versus Ward Procedure Room"],"prefix":"10.52628","volume":"91","author":[{"given":"A","family":"ZYLUK","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"JABLECKI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27062","published-online":{"date-parts":[[2025,5]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Leblanc MR, Lalonde J, Lalonde DH. A detailed cost and efficiency analysis of performing carpal tunnel surgery in the main operating room versus the ambulatory setting in Canada. Hand (NY) 2007; 2: 173-178.","DOI":"10.1007\/s11552-007-9043-5"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Gillis JA, Williams JG. Cost analysis of percutaneous fixation of hand fractures in the main operating room versus the ambulatory setting. J Plast Reconstr Aesthet Surg 2017; 70(8): 1044-1050.","DOI":"10.1016\/j.bjps.2017.05.011"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Kodumuri P, Jesudason EP, Lees V. Reducing the carbonfootprint in carpal tunnel surgery inside the operating room with a lean and green model: a comparative study. J Hand Surg Eur 2023; 48 (10): 1022-1029.","DOI":"10.1177\/17531934231176952"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Leblanc MR, Lalonde DH, Thoma A, Bell M, Wells N, Allen M, et al. Is main operating room sterility really necessary in carpal tunnel surgery? A multi-center prospective study of minor procedure room field sterility surgery. Hand (N Y) 2011; 6(1): 60-63.","DOI":"10.1007\/s11552-010-9301-9"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Bhutta MF. Our over-reliance on single-use equipment in the operating theatre is misguided, irrational and harming our planet. Ann R Coll Surg Engl 2021, 103: 709-712.","DOI":"10.1308\/rcsann.2021.0297"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Zhang D, Dyer G, Blazar P, et al. The environmental impact of open versus endoscopic carpal tunnel release. J Hand Surg Am 2023; 48: 46-52.","DOI":"10.1016\/j.jhsa.2021.12.003"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"van Denmark RE, Smith VJ, Fiegen A. Lean and green hand surgery. J Hand Surg Am 2018; 43: 179-181.","DOI":"10.1016\/j.jhsa.2017.11.007"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Kurtzman JS, Etcheson JI, Koehler SM. Wide-awake local anesthesia with no tourniquet: an updated review. Plast Reconstr Surg Glob Open, 2021; 9: e3507.","DOI":"10.1097\/gox.0000000000003507"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Connors KM, Guerra SM, Koehler SM. Current evidence involving WALANT surgery. J Hand Surg Glob Online, 2022; 4: 452-455.","DOI":"10.1016\/j.jhsg.2022.01.009"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Rizan C, Lillywhite R, Reed M, Bhutta MF. The carbon footprint of products used in five common surgical operations: identifying contributing products and processes. J R Soc Med 2023; 116(6): 199-213.","DOI":"10.1177\/01410768231166135"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Brodeur PG, Raducha JE, Patel DD, Cruz AI, Jr., Gil JA: Cost drivers in carpal tunnel release surgery: an analysis of 8,717 patients in New York State. J Hand Surg Am 2022; 47: 258-265.","DOI":"10.1016\/j.jhsa.2021.10.022"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Randall DJ, Peacock K, Nickel KB, Olsen MA, Kazmers NH: Moving minor hand surgeries out of the operating room and into the office-based procedure room: a population-based trend analysis. J Hand Surg Am 2022; 47:1137-1145.","DOI":"10.1016\/j.jhsa.2022.08.026"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Kronlage SC, Lomis MJ, Whitaker EA. Clinic carpal tunnel release surgery outcomes and high-value care. Cureus 2023; 15(7):e 42254. DOI 10.7759\/cureus.42254","DOI":"10.7759\/cureus.42254"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:46:55Z","timestamp":1755107215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actaorthopaedica.be\/archive\/volume-91\/issue-1\/hand-and-wrist\/comparison-of-costs-and-energy-expenditure-in-common-hand-surgery-operating-theatre-versus-ward-proc\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,5]]},"published-print":{"date-parts":[[2025,3]]}},"URL":"https:\/\/doi.org\/10.52628\/91.1.041026","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}