|
1
|
Shearman H, Yap SM, Zhao A, Passby L, Barrett A, Nikookam Y, Stoneham S, Myint NA, Phillips D, Dalal F, Wylie G, Costley M, Odedra S, Phillips M, Abbott RA, Wernham A, Tso S. A UK-wide study to describe resource consumption and waste management practices in skin surgery including Mohs micrographic surgery. Clin Exp Dermatol 2023; 48:1024-1029. [PMID: 37192414 DOI: 10.1093/ced/llad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/11/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND There is a lack of national guidance specifying how skin surgery, including Mohs micrographic surgery (MMS), should be conducted, leading to a degree of heterogeneity in the set-up of skin surgery services and how skin surgeries are performed. OBJECTIVES To provide the first UK-wide cross-sectional study reporting real-world data on the set-up and waste management practices of skin surgery, including MMS. METHODS A UK-wide service evaluation study was conducted between 1 March 2022 and 30 June 2022 using a standardized data collection pro forma. Twelve participating sites from England, Northern Ireland, Scotland and Wales provided data from 115 skin surgery lists involving 495 patients and 547 skin surgery procedures between 1 March 2022 and 30 June 2022. RESULTS Mean total weight of nonsharps skin surgery waste was 0.52 kg per procedure (0.39 kg clinical waste, 0.05 kg general waste and 0.08 kg recycling waste). Data from a single site using disposable surgical instruments reported a mean of only 0.25 kg of sharps waste per procedure. The recycling rate ranged between 0% and 44% across the cohort with a mean recycling rate of 16%. CONCLUSIONS We advocate that staff transition to the British Society of Dermatological Surgery 2022 sustainability guidance, which made wide-ranging recommendations to facilitate staff to transition to sustainable practices in skin surgery.
Collapse
Affiliation(s)
| | - Soo Min Yap
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - Andrew Zhao
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Lauren Passby
- Department of Dermatology, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Amy Barrett
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - Yasmin Nikookam
- Department of Dermatology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Sophie Stoneham
- Department of Dermatology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Nan Akari Myint
- Department of Dermatology, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Derrick Phillips
- Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
| | - Fatima Dalal
- Department of Dermatology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Grant Wylie
- Department of Dermatology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Matthew Costley
- Department of Dermatology, Belfast Health and Social Care Trust, Belfast, UK
| | - Sunita Odedra
- Department of Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Mirain Phillips
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - Rachel A Abbott
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - Aaron Wernham
- Department of Dermatology, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Dermatology, Walsall Healthcare NHS Trust, Walsall, UK
| | - Simon Tso
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| |
Collapse
|
|
2
|
Johnson-Ogbuneke J, Williamson T, Gamal N, Madhwapathi V, Hunt W, Wernham A, Tso S. Sustainability in delivering skin surgery training: additional resources consumed and opportunities for environmental gain using the Healthcare Environmental Performance Tool. Clin Exp Dermatol 2023; 48:250-253. [PMID: 36763736 DOI: 10.1093/ced/llac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 01/11/2023]
Affiliation(s)
- James Johnson-Ogbuneke
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - Tracey Williamson
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - Nahla Gamal
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
- Department of Dermatology, Menofia University, Egypt
| | - Vidya Madhwapathi
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - William Hunt
- Department of Dermatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Aaron Wernham
- Walsall Healthcare NHS Trust, Walsall, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Simon Tso
- Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
- Dermatology Sustainability UK Group, Warwick, UK
- VESTSO Ltd, Rugby, UK
| |
Collapse
|
|
3
|
Tso S. Environmental management systems and their relevance to dermatology. Clin Exp Dermatol 2023; 48:1-4. [PMID: 36669187 DOI: 10.1093/ced/llac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 01/21/2023]
Abstract
The International Organization for Standardization ISO 14000 family of standards and the European Commission Eco-Management and Auditing Scheme are examples of voluntary environmental management systems (EMS). EMS provides a framework to facilitate organizations to incorporate environmental considerations into their governance and operations to improve the use of resources and waste management practices. Organizations with EMS accreditation reported operational efficiency improvements and cost savings. This review article describes EMS and discusses their relevance to the dermatology sustainability.
Collapse
Affiliation(s)
- Simon Tso
- Dermatology Sustainability UK Group, Warwick, UK.,Jephson Dermatology Centre, South Warwickshire University NHS Foundation Trust, Warwick, UK
| |
Collapse
|