Observational studyBJS open2025
Environmental and financial cost of surgical-site infection by severity after lower limb vascular surgery.
Observational study in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Surgical Site Infections in Major Lower Limb Amputation (SIMBA): international multicentre study.BJS open · 2026Observational
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Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is sparse evidence of the relationship between environmental and financial costs of surgical-site infection. Identifying areas of high-cost burden would enable key targets for clinical interventions to aid in achieving the UK national net zero healthcare system strategies. The aim of this study was to evaluate the environmental and financial costs of surgical-site infection, subclassified by severity of infection.
methodsThis prospective observational study evaluated patients with and without surgical-site infection after a variety of lower limb vascular surgery using National Health Service and Personal and Social Services perspectives. The severity of surgical-site infection was defined using both Centers for Disease Control and Prevention and management-based criteria where patients with mild surgical-site infection required oral antibiotics, patients with moderate surgical-site infection required intravenous antibiotics, and patients with severe surgical-site infection required further surgical interventions.
resultsA total of 99 patients were included, with 22 patients (22.2%) diagnosed with surgical-site infection. The mean(s.d.) environmental cost without surgical-site infection was 10.3(24.3) kgCO2e (95% c.i. 4.8 to 15.9) per patient. Emissions increased with surgical-site infection severity, with mild producing 94.6(53.9) kgCO2e (95% c.i. 63.5 to 125.8, 918% increase), moderate producing 648(407.6) kgCO2e (95% c.i. -0.1 to 1296.6, 6291% increase) and severe producing 2651.4(2217.1) kgCO2e (95% c.i. -966.5 to 6347.2, 25 742% increase) per patient. The mean(s.d.) financial cost without surgical-site infection was €73.26(€160.27) (95% c.i. 36.91 to 109.72) that increased with severity, with mild costing €392.25(225.69) (95% c.i. 262.16 to 523.00, 536% increase), moderate costing €9754.46(5059.77) (95% c.i. 1704.65 to 17 820.68, 13 317% increase), and severe costing €37 035.60(32 910.84) (95% c.i. -15 376.07 to 89 447.52, 50 521% increase) per episode of infection (£1 = €1.20 (conversion date 25 October 2024)).
conclusionEnvironmental and financial costs are strongly correlated with surgical-site infection severity and display an exponential increase as severity increases. Overall, surgical-site infection incurs a cost of €15.58 for every kgCO2e produced. Environmental discounting should be explored and incorporated into sustainability assessments for robust accounting methodology. Surgical-site infection should be evaluated for severity rather than as a binary outcome for comprehensive assessment.
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