DS16 The cost of convenience: single-use vs. multiuse dermatological surgery sets in a tertiary dermatology department in Ireland

Abstract

Dermatological surgery contributes to climate change in a number of domains: from patient travel to surgical appointments, excessive packaging and surgical equipment itself. In response, the British Society for Dermatological Surgery have released sustainability guidance to enable improvements in local sustainability practices, including consumables such as surgical instruments. The aim of this study was to evaluate the true cost of single-use vs. multiuse surgical equipment in dermatology minor operative procedures. An economic and environmental analysis was performed of surgical sets in use in our tertiary dermatology department in Ireland from July 2024 to July 2025. An analysis of upfront equipment costs compared single-use (disposable) vs. multiuse (nondisposable) dermatological surgical sets. Decontamination cost estimates were provided for multiuse sets from our central sterile services department. The SusQI calculator was utilized to evaluate the environmental impact of single-use surgical sets. For upfront equipment costs, disposable sets containing a needle holder, scissors, toothed forceps and nontoothed forceps cost €5.75 per set. Over 12 months, 2000 disposable sets were ordered, totalling €11 500. Our streamlined nondisposable surgical sets contain a needle holder, scissors, toothed forceps, nontoothed forceps and scalpel handle, at approximately €333 per set. Upfront equipment purchase costs over 1 year for multiuse sets totalled €4060. To decontaminate nondisposable sets costs €14.59 per washer cycle (18 sets). To then sterilize and return sets to use costs €18.07 per autoclave cycle (nine sets). In total, 449 dermatology multiuse sets were decontaminated over 12 months, bringing the total cost of decontamination per minor surgical set to €2.82. In terms of environmental impact, the SusQI carbon footprint calculation for single-use surgical sets in 1 year in our department amounts to 1139 kg CO2 equivalent of carbon emissions (or 4669 kilometres in a petrol-powered car). Multiuse surgical equipment was more economically cost-effective and environmentally friendly than single-use, a small change that could have major positive implications for dermatological surgery.