What a Waste! The Impact of Unused Surgical Supplies in Hand Surgery and How We Can Improve

Dalibel Bravo, Cassandra Thiel, Ricardo Bello, Akini Moses, Nader Paksima, Eitan Melamed

Research output: Contribution to journalArticlepeer-review


Background: The US health care system is the second largest contributor of trash. Approximately 20% to 70% of waste is produced by operating rooms, and very few of this waste is recycled. The purpose of this study is to quantify the opened but unused disposable supplies and generate strategies to reduce disposable waste. Methods: A single-center prospective study to evaluate the cost of opened but unused single-use operating room supplies was completed by counting the number of wasted disposable products at the end of hand surgery cases. We used χ2 test, t test, Wilcoxon rank-sum test, and simple linear regression to assess the associations between patient and case variables and the total cost of wasted items. Environmentally Extended Input Output Life Cycle Assessment methods were used to convert the dollar spent to kilograms of carbon dioxide equivalent (CO2-e), a measure of greenhouse gas emissions. Results: Surgical and dressing items that were disposed of and not used during each case were recorded. We included 85 consecutive cases in the analysis from a single surgeon’s practice. Higher cost from wasted items was associated with shorter operative time (P =.010). On average, 11.5 items were wasted per case (SD: 3.6 items), with a total of 981 items wasted over the 85 cases in the study period. Surgical sponges and blades were 2 of the most unused items. Wasted items amounted to a total of $2193.5 and 441 kg of CO2-e during the study period. Conclusions: This study highlights the excessive waste of unused disposable products during hand surgery cases and identifies ways of improvement.

Original languageEnglish (US)
Pages (from-to)1215-1221
Number of pages7
Issue number7
StatePublished - Oct 2023


  • carbon footprint
  • greenhouse gas emissions
  • hand surgery
  • surgical waste
  • unused surgical supplies

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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