Reducing the environmental impact of surgery on a global scale : systematic review and co-prioritization with healthcare workers in 132 countries
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Antecedentes: la sanidad no puede alcanzar el cero neto de carbono sin abordar los quirófanos. El objetivo de este estudio fue priorizar intervenciones factibles para reducir el impacto ambiental de los quirófanos. Métodos: este estudio adoptó una metodología de consenso Delphi de copriorización en cuatro fases. En la fase 1 se utilizó una revisión sistemática de las intervenciones publicadas y una consulta global a profesionales sanitarios perioperatorios para elaborar una lista larga de intervenciones. En la fase 2, un análisis temático iterativo consolidó las intervenciones comparables en una lista corta. En la fase 3, la lista corta se copriorizó en función de las opiniones de pacientes y clínicos sobre aceptabilidad, factibilidad y seguridad. En la fase 4 se presentaron listas ordenadas de intervenciones según su relevancia para países de ingresos altos y países de ingresos medios-bajos. Resultados: en la fase 1 se identificaron 43 intervenciones, que presentaban una baja adopción en la práctica según 3042 profesionales de todo el mundo. En la fase 2 se generó una lista corta de 15 dominios de intervención. En la fase 3, las intervenciones se consideraron aceptables para más del 90 por ciento de los pacientes, excepto la reducción de la anestesia general (84 por ciento) y la reesterilización de consumibles de «un solo uso» (86 por ciento). En la fase 4, las tres principales intervenciones seleccionadas para los países de ingresos altos fueron: introducir el reciclaje; reducir el uso de gases anestésicos; y un procesamiento adecuado de los residuos clínicos. En la fase 4, las tres principales intervenciones seleccionadas para los países de ingresos medios-bajos fueron: introducir dispositivos quirúrgicos reutilizables; reducir el uso de consumibles; y reducir el uso de anestesia general. Conclusión: este es un paso hacia entornos quirúrgicos ambientalmente sostenibles, con intervenciones prácticas aplicables tanto a países de ingresos altos como de ingresos medios-bajos. [Traducción automática al español; idioma original: inglés.]
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Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
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