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

Thermal performance analysis of a phase change thermal storage unit for space heating

This paper presents the results of a comprehensive numerical study on the thermal performance of an air based phase change thermal storage unit (TSU) for space heating. The unit is designed for integration into space heating and cooling systems. The unit consists of a number of one dimensional phase change material (PCM) slabs contained in a rectangular duct where air passes between the slabs. The numerical analysis was based on an experimentally validated model. A parametric study has been carried out including the study on the effects of charge and discharge temperature differences, air mass flow rate, slab thicknesses, air gaps and slab dimensions on the air outlet temperatures and heat transfer rates of the thermal storage unit. The paper introduces and discusses quantities called charge and discharge temperature differences which play an important role in the melting and freezing processes.

Investigation of the thermal resistance of timber attic spaces with reflective foil and bulk insulation, heat flow up

An experimental investigation was undertaken in which the thermal resistance for the heat flow through a typical timber framed pitched roofing system was measured under outdoor conditions for heat flow up. The measured thermal resistance of low resistance systems such as an uninsulated attic space and a reflective attic space compared well with published data. However, with higher thermal resistance systems containing bulk insulation within the timber frame, the measured result for a typical installation was as low as 50% of the thermal resistance determined considering two dimensional thermal bridging using the parallel path method. This result was attributed to three dimensional heat flow and insulation installation defects, resulting from the design and construction method used. Translating these results to a typical house with a 200 m2 floor area, the overall thermal resistance of the roof was at least 23% lower than the overall calculated thermal resistance including two dimensional thermal bridging. When a continuous layer of bulk insulation was applied to the roofing system, the measured values were in agreement with calculated resistances representing a more reliable solution.

Validation of a mathematical model for encapsulated phase change material flat slabs for cooling applications

A one-dimensional liquid-based model for a flat slab phase change thermal storage unit was developed. The model allows for varying wall temperatures along the direction of flow and integrates a convective boundary layer using a previously developed algorithm, which is employed to iteratively calculate the liquid fraction and the temperature of each phase change material (PCM) node. The melting and freezing processes are analysed based on the temperatures of the heat transfer fluid nodes, the wall nodes and the PCM nodes during melting and freezing. The mathematical model developed was validated using two sets of experimental data obtained from tests using a PCM having a melting point of -26.7 degrees C and a liquid glycol based heat transfer fluid. The numerical results show a good agreement with the experimental ones.