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Waste Generation in Pediatric Orthopaedic Hardware Removal Surgery
Tyler M Staten1, Wade E Quilter1, Brittany N Garcia2
1Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
Journal of the Pediatric Orthopaedic Society of North America
|January 22, 2026
Summary
Pediatric hardware removal surgeries generate substantial waste, averaging 6.8 kg per case. Reducing this waste through better labeling and pack optimization can lower environmental and financial burdens.
Area of Science:
- Orthopaedic Surgery
- Environmental Health
- Healthcare Waste Management
Background:
- Hardware removal (ROH) is a common pediatric orthopaedic procedure.
- Surgeons must weigh ROH benefits against risks, costs, and waste generation.
- Understanding waste impact is crucial for patient and population health.
Purpose of the Study:
- To quantify and characterize intraoperative waste from pediatric ROH surgery.
- To identify key waste contributors and inform reduction strategies.
- To assess the environmental and financial impact of pediatric ROH waste.
Main Methods:
- Audit of 10 pediatric ROH cases at a tertiary care hospital.
- Collection, categorization, and weighing of all intraoperative waste.
- Classification of waste by usage (unused, used but not soiled, used and soiled) and labeling.
Main Results:
- Average of 6.8 kg of solid waste generated per case (range 5.3–8.1 kg).
- Drapes (1.2 kg) and hard plastics (1.14 kg) were major waste contributors.
- Only 11% of plastic waste had recycling labels; 7.76 kg of waste was unused.
Conclusions:
- Pediatric ROH generates significant waste, with potential national annual contribution exceeding 450,000 pounds.
- Clearer recycling labels, optimized procedure packs, and reduced draping can decrease waste.
- Balancing surgical benefits with waste reduction promotes high-value, sustainable care.
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