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Healthcare Associated Infections II: Preventive Measures01:22

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Green Cystoscopy: Does Minimizing the Use of Drapes Increase Infection Rates?

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Green draping in urogynecology is a safe alternative to traditional methods, reducing surgical site infections (urinary tract infections) and waste. This approach lowers the carbon footprint without compromising patient care.

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Area of Science:

  • Urology
  • Gynecology
  • Healthcare Sustainability

Background:

  • The U.S. healthcare system's significant carbon footprint is exacerbated by single-use surgical supplies.
  • Smaller surgical fields, termed 'green' draping, are emerging as a potentially safe alternative to traditional draping methods.

Purpose of the Study:

  • To assess if a green draping protocol is noninferior to standard draping for preventing culture-proven urinary tract infections (UTIs) within two weeks of operating room cystoscopy.
  • To identify risk factors for UTIs and quantify waste and cost savings associated with the green draping protocol.

Main Methods:

  • A pre-post implementation noninferiority study was conducted in a urogynecology division.
  • The study included minor cystoscopy cases from 2021 to 2023, comparing a green draping protocol (eliminating top drapes, leg drapes, and gowns) to pre-protocol standard draping.

Main Results:

  • The study included 240 patients; the green draping cohort showed noninferiority in preventing culture-proven UTIs (7.5% vs. 5.8%).
  • Risk factors for UTI included recurrent UTI history, interstitial cystitis/bladder pain syndrome, and older age.
  • The green draping protocol resulted in approximately $1,403.92 in savings and diverted 165 pounds of waste.

Conclusions:

  • The green draping protocol is noninferior to standard draping regarding postoperative culture-positive UTIs.
  • Implementing smaller operating room fields can reduce the healthcare carbon footprint without negatively impacting the quality of patient care.