Reducing Waste in Dermatologic Surgery: An Evidence-Based Review of Sustainability Strategies.

Vixey Silva, HCA Healthcare
Tory Starzyk, HCA Health
Mohammad Fardos, HCA Healthcare
Gili Amid-Toby
Stanislav N. Tolkachjov

Abstract

BACKGROUND: Dermatologic surgery generates considerable medical waste due to its high procedural volume, yet specialty-specific guidance on sustainable practices remains limited.

OBJECTIVE: To present an evidence-based framework for reducing waste in dermatologic surgery while maintaining safety and efficacy.

MATERIALS AND METHODS: A comprehensive search of PubMed was conducted for articles published from 2000 onward using key terms combining predefined waste reducing interventions (e.g. multipack nonsterile gloves, reusable drapes and instruments, longer-acting anesthetics, continuous suturing, simplified dressings) with ("waste reduction" OR "sustainability"). Evidence was graded by Oxford CEBM (1a-5) and GRADE (A-D).

RESULTS: Twenty-eight sustainability strategies were identified across the preoperative, intraoperative, and postoperative phases of dermatologic surgery, 15 of which were supported by level 1 to 2 evidence. High-level interventions included the use of nonsterile gloves, longer-acting anesthetics, reusable drapes and instruments, absorbable and continuous suturing techniques, and occlusive dressings.

CONCLUSION: This review summarizes evidence-based sustainability strategies shown to reduce environmental impact and provides a practical framework for potential implementation in dermatologic surgery.