Sustainability in foot and ankle surgery: Top tips and review of practices

Table 1 Providing 5 key take-home messages to change practices in foot and ankle surgery

Areas of improvement	Current practices	Recommendations
Operative practices	Standard surgical techniques are used routinely without consideration of sustainability impacts	Consider lower-impact alternatives that maintain clinical effectiveness (e.g., single-screw fixation where appropriate)
Theatre set-up	Routine use of laminar flow for all cases	Review the need for laminar flow in low-risk, non-implant procedures
Positioning adjuncts	Frequent use of single-use items for positioning adjuncts	Prioritise the use of reusable positioning adjuncts over single-use sterile alternatives where feasible
Drapes	Standard draping practices may involve multiple disposable drapes without procedure-specific consideration	Optimise drape type, size, and number; consider reusables
Post-operative immobilisation	Device choice driven by habit or availability	Review policies to improve cost-effectiveness and reduce carbon footprint