41 Surgical Gloves per Knee Surgery? Really?

Do surgeons need all those surgical gloves, sterile towels, gowns and drapes to replace one knee joint? Perhaps not, thought three medical students in London, Ontario, who conducted an audit of five knee replacement surgeries performed at the London Health Sciences Centre. As reported by Sharon Kirkey of Postmedia News, they found that the average surgical waste per surgery was 13.3 kilograms.

To replace one knee, surgeons used, on average, 64 plastic wrappers, 41 sterile surgical gloves, 29 green sterile towels, 10 vinyl gloves, 5 surgical gowns, 5 surgical drapes, 3 table covers and an assortment of sponges and gauzes. The authors reported that a routine operation “produces more waste than a family of four produces in an entire week.” When extrapolated to the more than 47, 000 knee replacements performed in Canada in 2008-2009, the authors estimated that knee surgeries generated 407, 889 kg by weight of landfill waste.

Douglas Naudie, M.D., associate professor in the department of surgery at the Schulich School of Medicine and Dentistry at Western University and consultant orthopedic surgeon at London Health Sciences Centre, is the surgeon the students audited. He was surprised by the amount of waste generated by knee replacement. “I had no idea. I think it kind of opened our eyes a lot.”

Since the audit, Naudie’s hospital has initiated several strategies, including more recycling and ensuring waste is properly separated into “normal” and infectious waste. Kirkey reported on studies showing that up to 85% of non-hazardous solid waste is disposed of as infectious waste requiring “high energy” treatment processes. This includes incineration that is not only harmful to the environment but costs 10 to 20 times more. The London, Ontario, hospital has also reduced by nearly half the number of items that are opened and prepared for surgery but never used.