Introduction
A recent international consensus has shown a move away from using sterile gowns for coblation adenoidectomy +/- tonsillectomy.
Coblation tonsillectomy is a quicker procedure with less blood loss compared to traditional methods (1). Otolaryngology surgery produces 1.7 kg of waste per case (2), with each sterile gown having a carbon footprint of 2,896.19 g CO2e (3).
A recent study reported that 34.9% of ENT specialists were happy wearing sterile gloves only to perform a tonsillectomy (2). We surveyed our local department to determine if local practice correlated with reported statistics.
Methods
An anonymous intra-departmental survey was distributed and results collated. Permission was granted by the trust audit team and the sustainability team were consulted.
Results
62.5% of respondents use sterile gloves only when performing a coblation tonsillectomy. The remainder use a sterile gown. 50% of respondents were unsure if sterile gowns should be worn. Justifications were varied mentioning the clean-contaminated nature of the procedure, variations in consultant preference and concern about dealing with intra-operative complications.
Conclusion
These initial results suggest a willingness to adopt more sustainable practice in keeping with the circular economy in healthcare alliance.
Benefits include a reduced carbon footprint, cost and procedure duration, improved staff wellbeing owing to increased cognitive capacity, and the snowball effect for other procedures.
Attaining long term cultural change may be difficult given the nature of rotational training.
As a result of this audit, we plan to collaborate with departmental leads, infection control and the sustainability team to change local practice.
References
1. Omrani M, Barati B, Omidifar N, Okhovvat AR, Hashemi SA. Coblation versus traditional tonsillectomy: A double blind randomized controlled trial. J Res Med Sci. 2012 Jan;17(1):45-50. PMID: 23248656; PMCID: PMC3523437.
2. Thakrar J, Patel A, Joseph J. UK national survey on surgical gowning for tonsillectomy. The Journal of Laryngology & Otology. 2024;138(8):845-848. doi:10.1017/S0022215124000331
3. Sterile surgical gown in Lancet MedZero Database. Lancet MedZero. 2026. https://www.medzerocarbon.com. (21 June 2026).