Environmental Sustainability in Curette and Cautery Skin Surgery: A Quality Improvement Project on Single-Centre Transformation to Sustainable Practices

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Simon Tso
Tracey Williamson
Mi Joo Choi
Becky Seeley
Enenche Edache
Rosie Hillson
Rachel McLean


In this sustainability quality improvement project, we proposed a new lean pathway for performing curette and cautery minor skin surgery and evaluated our project’s social, patient, economic, environmental and population outcomes. If the new lean pathway is embedded into routine clinical practice, this could potentially lead to £4.08 (excluding VAT) and 1.24 kgCO2e per procedure of costs and carbon emissions savings, respectively. Surgical site infection rates for procedures performed with sterile gloves (n = 12) and non-sterile nitrile gloves (n = 8) were both at 0%. Our small single-centre study demonstrated that transforming to sustainable practices for curette and cautery procedures can lead to significant triple-bottom-line benefits with no obvious adverse postoperative infection risks. We encourage dermatology staff from the public and private sectors, as well as staff from other specialties, to consider adopting the recommendations from the British Society of Dermatological Surgery sustainability guidance when performing curette and cautery procedures.

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