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Application of Lean Methodologies in Plastic Surgery: A Systematic Review.

Poppy MacInnes¹, Samruddhi Tagalpallewar^1,2, Isabelle M Y Wood¹

¹From the Royal Free Trust Hospital, London, United Kingdom.

Plastic and Reconstructive Surgery. Global Open

|March 23, 2026

Summary

Lean management (LM) principles significantly improved efficiency and reduced waste in plastic surgery departments. This approach enhanced patient flow and satisfaction, though its impact on morbidity and mortality requires further investigation.

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Area of Science:

Healthcare Management
Surgical Operations
Process Improvement

Background:

Lean management (LM) principles, originating from Toyota, aim to optimize efficiency and minimize waste in production systems.
This review systematically evaluates the application and impact of LM in plastic surgery settings.

Purpose of the Study:

To assess the effectiveness of lean management (LM) in enhancing efficiency and reducing waste within plastic surgery departments.
To identify key outcomes associated with LM implementation in plastic surgery.

Main Methods:

A systematic review of studies published between January 2008 and October 2023 was conducted.
Included studies were prospective, retrospective, or comparative, published in English, and focused on LM in plastic surgery.

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Data synthesis involved comparing effect measures as reported due to outcome heterogeneity.

Main Results:

Nineteen studies involving 3208 patients demonstrated positive outcomes from LM implementation.
Key improvements included reduced operating room time, cost savings, shorter hospital stays, and increased patient and staff satisfaction.
Morbidity and mortality rates remained largely unchanged across the majority of studies.

Conclusions:

Lean management offers a viable framework for optimizing service delivery and improving patient and staff satisfaction in plastic surgery.
Addressing service pressures necessitates enhanced sustainability and patient flow, achievable through LM.
Further research is required to elucidate the effects of improved efficiency on patient morbidity and mortality outcomes.