[Perianal surgery in a non-sterile setting: risks, cost-saving ad climate benefits]

Sustainable healthcare is essential to reduce environmental impact without compromising patient safety. This study investigates whether minor perianal surgery can be safely performed under a non-sterile condition, aiming to reduce material use, costs, and CO2-emissions, and whether these findings can be incorporated into a widely supported surgical protocol.

A retrospective cohort study was conducted among patients who underwent minor perianal surgery under sterile or non-sterile conditions. Primary outcomes were postoperative wound infections (POWIs) within 30 days, cost savings, and CO2-reduction. A literature review and a survey among surgeons regarding the treatment of perianal abscesses were also conducted.

263 patients were included. POWI rates did not differ significantly between the groups. A non-sterile approach can save at least €1925 per hospital annually and significantly reduce CO2 -emissions. Nearly all surgeons considered sterile conditions unnecessary for the treatment of perianal abscesses.

Non-sterile conditions for perianal surgery are both cost-effective and more sustainable. Moreover, there is strong support for implementations of this change among surgeons.