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

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

Estabilidade Microbiológica de Carnes de Boi, Porco e Cabra, Tratadas com Sorbato de Potássio.

Foi avaliado o efeito do sorbato de potássio sobre a qualidade microbiológica de carnes frescas de boi, porco e cabra. Para tal as carnes foram cortadas em troços pesando cerca de 50 g cada, sendo estas, imersas numa solução de sorbato de potássio a 5, 10 ou 15%, com agitação constante por um minuto. Ap6s drenagem as amostras foram embaladas em sacos de polietileno e mantidas sob refrigeração (20Q ou à temperatura ambiente (280C), por até 48 horas. As amostras de carne foram analisadas para bactérias do gênero Salmonella, do grupo coliforme fecal, mes6filas e Staphylococcus aureus coagulase positiva antes e ap6s 24 e 48 horas do tratamento com sorbato. Houve um decréscimo do número de bactérias mesófilas e de coliformes fecais nos tratamentos com sorbato, especialmente naqueles tratados com soluções a 10 e 15% e estocados sob refrigeração, em relação ao tratamento sem sorbato. Nenhuma das amostras analisadas mostrou-se positiva para salmonelas; e S. aureus. O efeito inibit6rio do sorbato de potássio foi maior sobre as carnes de boi e porco, que sobre a de cabra.Made available in DSpace on 2011-04-09T12:21:34Z (GMT). No. of bitstreams: 1 pab11out91.pdf: 338306 bytes, checksum: 1461763e6d776f03762d0e1750f21628 (MD5) Previous issue date: 2002-02-07199