Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway

Background:. Autologous microtia reconstruction is a highly specialized procedure with the potential to significantly improve patient quality of life. However, it has a complex patient pathway including a multistaged procedure, the environmental impact of which has yet to be explored. Methods:. A re...

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Main Authors: Zahra Ahmed, BSc (Hons), Alexander Zargaran, MRCS, Yasmin Kamel, MBBS, Sara Sousi, MRes, Punn Tannirandorn, BSc (Hons), David Zargaran, MRCS, Walid Sabbagh, FRCS (Plast), Gregory O’Toole, FRCS (Plast), Afshin Mosahebi, FRCS (Plast)
Format: Article
Language:English
Published: Wolters Kluwer 2025-05-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006746
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author Zahra Ahmed, BSc (Hons)
Alexander Zargaran, MRCS
Yasmin Kamel, MBBS
Sara Sousi, MRes
Punn Tannirandorn, BSc (Hons)
David Zargaran, MRCS
Walid Sabbagh, FRCS (Plast)
Gregory O’Toole, FRCS (Plast)
Afshin Mosahebi, FRCS (Plast)
author_facet Zahra Ahmed, BSc (Hons)
Alexander Zargaran, MRCS
Yasmin Kamel, MBBS
Sara Sousi, MRes
Punn Tannirandorn, BSc (Hons)
David Zargaran, MRCS
Walid Sabbagh, FRCS (Plast)
Gregory O’Toole, FRCS (Plast)
Afshin Mosahebi, FRCS (Plast)
author_sort Zahra Ahmed, BSc (Hons)
collection DOAJ
description Background:. Autologous microtia reconstruction is a highly specialized procedure with the potential to significantly improve patient quality of life. However, it has a complex patient pathway including a multistaged procedure, the environmental impact of which has yet to be explored. Methods:. A retrospective study of 23 patients undergoing autologous microtia reconstruction at a single center was performed. Process mapping and life cycle analyses were performed for surgical and inpatient stay, including facilities, consumables, medical gases, equipment, food and linen, and travel. Estimates for carbon dioxide emissions were generated for each stage of the care pathway, with variability considered, as well as potential areas of savings. Results:. This study estimated the carbon footprint of a patient undergoing autologous microtia reconstruction surgery to be approximately 1004.5 kgCO2eq. Inpatient stay had the highest overall contribution to the carbon footprint (447.5 kgCO2eq, 44.6% overall). From bottom-up calculations, patient travel was the predominant source of carbon emissions (464.2 kgCO2eq, 83.4%). Conclusions:. This was the first study to estimate the carbon footprint of a quaternary plastic surgery procedure, using autologous microtia reconstruction as an example. Strategies to combat the impact of carbon emissions, including adapted models of care in a hub-and-spoke model, reduction in the use of anesthetic gases, and facilitating sustainable staff travel, were suggested areas for improvement.
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spelling doaj-art-f07be0ca88d44cd989fbf46a7217e66a2025-08-20T02:29:16ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-05-01135e674610.1097/GOX.0000000000006746202505000-00029Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction PathwayZahra Ahmed, BSc (Hons)0Alexander Zargaran, MRCS1Yasmin Kamel, MBBS2Sara Sousi, MRes3Punn Tannirandorn, BSc (Hons)4David Zargaran, MRCS5Walid Sabbagh, FRCS (Plast)6Gregory O’Toole, FRCS (Plast)7Afshin Mosahebi, FRCS (Plast)8From the * University College London, London, United KingdomFrom the * University College London, London, United Kingdom‡ University of Buckingham Medical School, Milton Keynes, United Kingdom.From the * University College London, London, United KingdomFrom the * University College London, London, United KingdomFrom the * University College London, London, United Kingdom† Royal Free NHS Foundation Trust, London, United Kingdom† Royal Free NHS Foundation Trust, London, United KingdomFrom the * University College London, London, United KingdomBackground:. Autologous microtia reconstruction is a highly specialized procedure with the potential to significantly improve patient quality of life. However, it has a complex patient pathway including a multistaged procedure, the environmental impact of which has yet to be explored. Methods:. A retrospective study of 23 patients undergoing autologous microtia reconstruction at a single center was performed. Process mapping and life cycle analyses were performed for surgical and inpatient stay, including facilities, consumables, medical gases, equipment, food and linen, and travel. Estimates for carbon dioxide emissions were generated for each stage of the care pathway, with variability considered, as well as potential areas of savings. Results:. This study estimated the carbon footprint of a patient undergoing autologous microtia reconstruction surgery to be approximately 1004.5 kgCO2eq. Inpatient stay had the highest overall contribution to the carbon footprint (447.5 kgCO2eq, 44.6% overall). From bottom-up calculations, patient travel was the predominant source of carbon emissions (464.2 kgCO2eq, 83.4%). Conclusions:. This was the first study to estimate the carbon footprint of a quaternary plastic surgery procedure, using autologous microtia reconstruction as an example. Strategies to combat the impact of carbon emissions, including adapted models of care in a hub-and-spoke model, reduction in the use of anesthetic gases, and facilitating sustainable staff travel, were suggested areas for improvement.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006746
spellingShingle Zahra Ahmed, BSc (Hons)
Alexander Zargaran, MRCS
Yasmin Kamel, MBBS
Sara Sousi, MRes
Punn Tannirandorn, BSc (Hons)
David Zargaran, MRCS
Walid Sabbagh, FRCS (Plast)
Gregory O’Toole, FRCS (Plast)
Afshin Mosahebi, FRCS (Plast)
Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
Plastic and Reconstructive Surgery, Global Open
title Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
title_full Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
title_fullStr Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
title_full_unstemmed Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
title_short Evaluating the Environmental Impact of Quaternary Plastic Surgery: An Eco-audit of the Autologous Microtia Reconstruction Pathway
title_sort evaluating the environmental impact of quaternary plastic surgery an eco audit of the autologous microtia reconstruction pathway
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006746
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