PPE use in Moh’s Micrographic Surgery
Mohs Micrographic Surgery (MMS) is a surgical operation in which skin cancers (namely basal cell carcinomas and squamous cell carcinomas) are removed. These lesions are removed and immediately viewed under the microscope to ensure all skin margins are clear of cancer cells (image 1). For this procedure, we usually utilise surgical personal protective equipment (PPE) which includes 2 sterile glove pairs and 2 surgical gowns.
The environmental impact of healthcare is well reported, accounting for 4-5% of global greenhouse emissions. Sterile gloves and surgical gowns seem to have a larger impact on our planet. They are often non-recyclable and end up in our landfills, which can ultimately pollute the ocean and disrupt sea life. Polypropylene waste from face masks, single use gloves and surgical gowns can equate to 1 million tonnes per month.
To help reduce our carbon footprint, we decided to utilise 1 plastic apron and 2 non-sterile glove pairs in place of sterile PPE from August 2020 in the Dermatology department. Interestingly, our data has revealed no significant differences in post-operative wound infections with using nonsterile PPE. Out of 410 MMS procedures, only 1.7% saw a minor post operative complication relating to infection. In addition, using non-sterile PPE has saved our department £1,471.90 between August 2020 and September 2022 alone, allowing for funding to be distributed to other areas of dermatology, to further improve our patient experiences.
By using less PPE in minor surgical operations like MMS, we are reducing plastic wastage. Despite not being able to completely remove PPE for our daily practices, we can make the PPE we do use, more sustainable, to help save the planet we live in!
