398 Theatre Waste Management and the Impact of COVID-19

Introduction

Audit of waste management in an elective orthopaedic complex was interrupted due Covid-19 pandemic. We investigated the impact of the enforced changes on theatre waste due to Covid-19.

Method

Over a 1week period data on waste bag availability and number of bags of each category of waste per surgical case in an elective theatre complex was collated; this was compared to waste generated during Covid-19 pandemic.

Results

Prior to Covid-19 only clinical waste bins were available in many non-dominant clinical areas providing evidence of inappropriate routine disposal of domestic/recyclable waste. Pre-Covid-19 a mean of 6waste bags were used per surgical case (3.7yellow clinical bags, 1.3black domestic bags, 0.4clear recycling bags), with Covid-19 changes to waste management practice the mean number of waste bags used per case increased to 11 (9 orange contaminated bags, 0.5black, 0.3clear bags).

Conclusions

Clinical waste management has a significant economic and environmental impact. Covid-19 has led to nearly all waste being deemed to be contaminated and so requiring incineration, with increased volumes of waste generated per case through widespread adoption of PPE. This has increased cost and reduced the ability to recycle non-contaminated waste.

397 Impact of COVID-19 on Theatre Utility

Introduction

Covid-19 has significantly impacted the environment in which surgeons operate. Level-2 PPE is worn in our orthopaedic theatres, with increased time taken for simple tasks due to claustrophobia, excessive heat, and difficulties in communication due to masks, including donning and doffing. We sought to determine the impact of Covid-19 on theatre utility.

Method

8week period during Covid-19 was reviewed for semi-elective orthopaedic surgery. Pre-Covid-19 case controls for age, procedure and ASA were identified. Electronic database was used to determine total time in theatre complex, time taken for anaesthesia, total procedure time, and time taken for patient to leave the theatre.

Results

27patients undergoing semi-elective surgery during Covid-19 pandemic and 27-matched controls from before pandemic were identified. No statistically significant difference in procedural or anaesthetic time. Significant difference in time interval between cases (14minutes pre-Covid-19 v 58minutes during Covid-19; p < 0.05). Mean theatre start times are 51minutes later during Covid-19.

Conclusions

Procedural times of surgery have not significantly increased, however the time between cases has increased; resulting in a decrease in overall theatre complex utility and direct impact on future costing.