Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
The intraoperative carbon footprint of burn surgery: A prospective case-level analysis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Goodarzi Mohammad R, Sutcliffe Alexandra, Abdulla Hajar, Muscat Edward, Dhillon Dharminder, Lewis Christopher J
Аннотация
BACKGROUND: Healthcare contributes to approximately 4-5% of global greenhouse gas emissions. Burn surgery is particularly resource intensive; however, its environmental impact has not been quantified at the case level. We aimed to evaluate the carbon footprint of burn surgery and identify its key drivers.
METHODS: A prospective observational study was conducted at a UK regional burns centre by including adult and paediatric burn procedures. Carbon emissions were calculated in kilograms of carbon dioxide equivalent (kg CO₂e) using published life-cycle assessment data and NHS emission factors. Linear and multivariable regression were used to assess the predictors of emissions.
RESULTS: Fifty-two procedures were analysed (in 49 adults and 3 paediatric patients; burn size 0.2-85% TBSA). Mean intraoperative carbon footprint was 158 kg CO₂e per case (range 40-875 kg CO₂e). Emissions increased by 9 kg CO₂e per 1% increase in TBSA (R²=0.75, p<0.001). Consumables accounted for 67% of total emissions, followed by theatre energy (20%) and anaesthesia (13%). Use of advanced single-use adjuncts was associated with higher emissions on univariate analysis. On an average, a single burn operation generated emissions equivalent to approximately 800 miles of petrol vehicle travel.
CONCLUSIONS: Burn surgery is associated with substantial intraoperative carbon emissions that scale primarily with burn size and consumable use. Although burn severity is non-modifiable, targeted measures-including adoption of reusable textiles, optimisation of theatre ventilation, rationalisation of consumables and preferential use of TIVA-offer practical opportunities to reduce environmental impact without compromising care. These data provide a quantitative benchmark for burn surgery and support integration of carbon metrics into routine audit to guide sustainable clinical practice.
METHODS: A prospective observational study was conducted at a UK regional burns centre by including adult and paediatric burn procedures. Carbon emissions were calculated in kilograms of carbon dioxide equivalent (kg CO₂e) using published life-cycle assessment data and NHS emission factors. Linear and multivariable regression were used to assess the predictors of emissions.
RESULTS: Fifty-two procedures were analysed (in 49 adults and 3 paediatric patients; burn size 0.2-85% TBSA). Mean intraoperative carbon footprint was 158 kg CO₂e per case (range 40-875 kg CO₂e). Emissions increased by 9 kg CO₂e per 1% increase in TBSA (R²=0.75, p<0.001). Consumables accounted for 67% of total emissions, followed by theatre energy (20%) and anaesthesia (13%). Use of advanced single-use adjuncts was associated with higher emissions on univariate analysis. On an average, a single burn operation generated emissions equivalent to approximately 800 miles of petrol vehicle travel.
CONCLUSIONS: Burn surgery is associated with substantial intraoperative carbon emissions that scale primarily with burn size and consumable use. Although burn severity is non-modifiable, targeted measures-including adoption of reusable textiles, optimisation of theatre ventilation, rationalisation of consumables and preferential use of TIVA-offer practical opportunities to reduce environmental impact without compromising care. These data provide a quantitative benchmark for burn surgery and support integration of carbon metrics into routine audit to guide sustainable clinical practice.