Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Enhanced the structure and optical properties for ZnO/PVP nanofibers fabricated via electrospinning technique

International audienceZinc oxide/polyvinylpyrrolidone (ZnO/PVP) nanocomposite fibers with enhanced structural, morphological and optical properties were purposefully tailored using electrospinning technique. Meanwhile, ZnO nanoparticles (NPs),with particle size of ~50 nm, were synthesized using a co-precipitation method. The nanocomposite fibers were prepared by an electrospun solution of PVP containing ZnO NPs of 2, 4, 6 and 8 wt%. Evidently, the morphological, thermal and optical properties of the ZnO/PVP nanocomposite fibers were enhanced by dispersing ZnO NPs into PVP fibers. Typically, controlling the ZnO NPs content and their dispersibility (0–8 wt%) into PVP fibers result in improved the thermal stability (an increase of onset decomposition temperature by ~120 °C above pure PVP fibers) as well as the UV–Vis protection (reduction in UV transmission by 70%) and the photoluminescence properties (a sharp UV emission around 380 nm) Overall, based on the enhanced properties, the PVP/ZnO nanocomposite fibers can be considered a promise material in optoelectronic sensors and UV photoconductor