USE LESS, a Comparative Cohort Study of Climate Change Impact From Orthopedic Surgery

NCT07657039 | Recruiting

• 1 other identifier: 2025-02587-01
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

A prospective comparative cohort study with the objective to quantify and compare carbon dioxide equivalent (CO₂e) emissions from orthopedic surgeries performed in two different operating room (OR) settings using different sets of materials and staff.

Conditions

Environment; Waste Output

Keywords

Climate change impact; greenhouse gases; environment; Life Cycle Assessment; Single-use materials

Outcome Measures

Primary Outcomes (1)

• Climate change impact

  Mean carbon dioxide equivalent (CO₂e) emissions expressed in kgs per functional unit defined as one performed surgery. All single-use materials consumed during an operation will be registrered, categorized, weighted and converted into CO₂e using exsisting LCAs or databases. Energy comsuption for machines in the OR, heating and ventilation of the OR and for sterilization of reusable materials will be converted into CO2e using existing databases. Water usage for sterilization will be calculated and converted into CO₂e using databases.

  Data cwill be collected during 12 months for each group

Secondary Outcomes (4)

• Readmission

  within 90 days of the performed sugery

• Combustible waste

  All consecutive suergeries for twelve months in each group

• Costs

  All consecutive suergeries for twelve months in each group

• Infections

  Within 90 days of surgery

Other Outcomes (1)

• Hotspot analysis

  All consecutive suergeries for twelve months in each group

Study Arms (2)

Control group

Patients undergoing surgical procedures in an operating room at the day surgery department

Intervention group

Patients undergoing surgical procedures in the procedure room at the orthopedic outpatient clinic

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients above the age of 18 undergoing stated procedures at Danderyd's hospital.

You may qualify if:

• The following surgeries will be included: release of carpal tunnel or trigger finger, wound revision or amputation of finger or toe, extraction of osteosynthesis material or suturing of extensor tendon (hand or foot) at Danderyd's Hospital.

You may not qualify if:

• None

Sponsors & Collaborators

• Karolinska Institutet: lead

Study Sites (1)

Danderyd's Hospital

Stockholm, Sweden

RECRUITING

Related Publications (10)

• Keil M, Viere T, Helms K, Rogowski W. The impact of switching from single-use to reusable healthcare products: a transparency checklist and systematic review of life-cycle assessments. Eur J Public Health. 2023 Feb 3;33(1):56-63. doi: 10.1093/eurpub/ckac174.

  PMID: 36433787 BACKGROUND

• 8: Ted Schettler, M., Polyvinyl chloride in health care. 2020.

  BACKGROUND

• 7: WOLF, M.-A., et al., International reference life cycle data system (ILCD) handbook-general guide for life cycle assessment-detailed guidance. 2010.

  BACKGROUND

• Rizan C, Lillywhite R, Reed M, Bhutta MF. The carbon footprint of products used in five common surgical operations: identifying contributing products and processes. J R Soc Med. 2023 Jun;116(6):199-213. doi: 10.1177/01410768231166135. Epub 2023 Apr 13.

  PMID: 37054734 BACKGROUND

• Grothaus O, Jorgensen A, Maughan G, Anto M, Kazmers NH, Garcia BN. Carbon Footprint of Open Carpal Tunnel Release Surgery Performed in the Procedure Room Versus Operating Room Setting. J Hand Surg Am. 2024 Jun;49(6):576-582. doi: 10.1016/j.jhsa.2024.03.014. Epub 2024 May 6.

  PMID: 38713110 BACKGROUND

• Rizan C, Steinbach I, Nicholson R, Lillywhite R, Reed M, Bhutta MF. The Carbon Footprint of Surgical Operations: A Systematic Review. Ann Surg. 2020 Dec;272(6):986-995. doi: 10.1097/SLA.0000000000003951.

  PMID: 32516230 BACKGROUND

• 3: Boiko, P., et al., Environmental life cycle assessment of surgical versus conservative care pathways for an anterior cruciate ligament injury. Journal of cleaner production, 2025. 535: p. 147136.

  BACKGROUND

• Eidmann A, Geiger F, Heinz T, Jakuscheit A, Docheva D, Horas K, Stratos I, Rudert M. Our Impact on Global Warming: A Carbon Footprint Analysis of Orthopaedic Operations. J Bone Joint Surg Am. 2024 Nov 6;106(21):1971-1977. doi: 10.2106/JBJS.24.00212. Epub 2024 Sep 19.

  PMID: 39503716 BACKGROUND

• 1:Pichler, P.-P., et al., International comparison of health care carbon footprints. Environmental research letters, 2019. 14(6): p. 064004

  BACKGROUND

• Shah S, Morris H, Thiagarajah S, Gordon A, Sharma S, Haslam P, Garcia J, Ali F. Handling 'carbon footprint' in orthopaedics. Ann R Coll Surg Engl. 2024 Jul;106(6):498-503. doi: 10.1308/rcsann.2023.0052. Epub 2024 Apr 2.

  PMID: 38563077 RESULT

Central Study Contacts

Marianne Smith, MD

CONTACT

+46737803594; marianne.smith@regionstockholm.se

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor

Study Record Dates

• First Submitted: June 11, 2026
• First Posted: June 18, 2026
• Study Start: September 1, 2025
• Primary Completion (Estimated): August 31, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: June 18, 2026

Record last verified: 2026-06

Locations

SE (1)