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Surgery and water

Climate change, greenhouse gases, carbon footprints: these are words we hear almost everyday. The tsunamis in South‐East Asia, hurricanes such as Katrina, floods in Europe: all are natural disasters that are becoming almost second nature to today's world. Water is something we sometimes take for granted. 
 
Water is an essential natural resource for the surgeon in order to be able to start the journey to the sterile surgical field before operating. With a surgical scrub sink producing 1 litre in 5–6 seconds and the recommended scrubbing time to be 5 minutes, a surgeon per operation could use up to 50 litres of water at a cost of approximately 0.036 pence per litre; it would be 0.71 pence per cubic metre. This is a lot of water being wasted not to mention the cost of the water not used. 
 
‘Water, water everywhere but not enough to drink’, should make us think and remember the future and also what is currently happening in other parts of the world. Water is potentially the next fuel to be in demand globally. We think about how to cut our water bills at home and tend to think of the cost incurred by running a domestic tap when it flows at about 15 litres per minute but not much thought when we are at work. We have a good source of water in the UK and it is time to take action and responsibility to preserve it as wasting it will eventually harm the environment. 
 
Surgeons make use of water daily but the amount is variable based on the type of water supply facility available for scrubbing in the operating theatre. With national and international concerns about recession, appropriate use of finances in the National Health Service (NHS) is of paramount importance. Spending money to save money is a concept that is commonly under‐utilized. At the time of World War II, when water supply in England was short, an easy method of obtaining water for scrubbing in order to utilize every ounce and avoid the need for someone to pour water over the hands at desired intervals was developed. This was essentially an early model of the foot pedal‐operated sinks with a can, rubber tubing and cut‐off produced by wooden jaws. Buying sensor‐controlled or pedal‐operated taps in operating theatres for an additional £400–£600 will in the long term reduce wastage and water bills which can then be used for other essential resources. Hence, reducing the amount of water that flows unused during scrubbing could provide a saving for the hospital and the environment. 
 
Small steps to change lead to significant outcomes. Encouraging pharmaceutical and medical supply companies to reduce unnecessary packing and to use more eco‐friendly products is an essential step. There should be recycling bins in theatre areas so that cardboard and plastic waste can be recycled. As doctors we need to show leadership through environmental culture change, and make operating theatres less eco‐unfriendly.