A quantitative, qualitative, and critical assessment of surgical waste. Surgeons venture through the trash can.

OBJECTIVES: To quantitatively and qualitatively evaluate the surgical waste produced from several common surgical procedures, define categories of waste that might be readily separated for alternative disposal practices or substitution, and determine the change in surgical waste output that elimination or alternative handling methods may effect.
DESIGN: A case series evaluating the surgical waste from five types of surgical procedures including operations of the back, heart, abdomen, hip and knee, and herniorrhaphies, prospectively identified and allocated at the availability of the investigator.
SETTING: A single tertiary community teaching hospital. OUTCOME MEASURES: Weight, volume, and percentage of disposable linen, paper, and plastic plus miscellaneous material from surgical waste with a later subset separating plastics from miscellaneous items to completely identify all categories.
RESULTS: Surgical waste weighing 610.5 lb (274.7 kg) and occupying 171.6 cu ft (5.1 m3) from 27 cases was examined. Disposable linens accounted for 39% of the weight; paper, 7%; plastic, 26%; and miscellaneous waste, 27%. By volume, disposable linen and paper accounted for 69%; plastic, 23%; and miscellaneous waste, 7%. Disposable linen, paper, and recyclable plastic accounted for 73% +/- 7% (mean +/- SD) by weight and 93% +/- 4% by volume of total surgical waste.
CONCLUSION: Nationally, annual surgical waste from these five procedures weighs 5.1 x 10(7) lb (2.3 x 10(7) kg) and occupies 1.4 x 10(7) cu ft (4.0 x 10(5) m3). By using reusable linen products and engaging in recycling methods currently available and feasible, we estimate that weight reductions of 73% and volume reductions of 93% in surgical waste are possible.