Evaluation of ‘green’ pulsatile lavage system in orthopaedic surgery

SusQI project completed as part of The Gloucestershire Hospitals NHS FT Green Team Competition from September - December 2022.

Setting/Patient Group: Orthopaedic surgery – trust-wide

Issue to be addressed:

Pulse lavage is widely used in orthopaedic surgery, playing an important role in common procedures such as knee and hip replacements. The current pulse lavage system (Pulsvac Plus) is single use, disposable and battery operated (8x AA).

Intervention:

A two-week trial of a novel low carbon alternative (Ecopulse) which is powered via the power tool handpiece already in use on joint replacement sets, removing the battery waste and reducing the size and weight of the product.

Outcome:

Clinical

• Ecopulse was favoured well in the clinical trial period and was acceptable for most surgeons.
• Ecopulse is heavier once attached to the power tool and technical difficulty with simultaneous mechanical brush use, so not appropriate across the board.

Social

• Ecopulse is quieter, improving the working environment for staff.

Environmental

• Assuming, 95% of cases are eligible to switch to the Ecopulse we project a saving of 4,501.1 kgCO2e.

Economic

• Based on a procurement of 2,500 pulse lavage kits per year and 95% use the Ecopulse, projected savings £6,175 per year.

Key learning point

Teams should prioritise reviewing single use items used in high volume operations such as joint replacement surgery. There is a growing market for “green” alternatives in surgical instruments and it represents a significant opportunity to make carbon savings at your trust.

Click here for more information on the Green Team Competition (including organisation impact reports).