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Utilisation of Plastic Surgery Theatres in a Single UK Centre

Harry Lobb

Given the average cost of a NHS operating the-
atre is £1,200 per hour, it is essential that op-
timal utilisation is achieved. There are no standard

guidelines for plastic surgery theatre utilisation. UK

governmental institutions have suggested that oper-
ating departments should aim for 90% utilisation but

there has been little research to validate the target
of 90%. In 2018, the NHS Benchmarking Network’s
Operating Theatres project suggested a minimum of

83% utilisation should be achieved by general sur-
gery theatres. In this study, the database ‘Opera’ was

accessed to retrospectively analyse plastic surgery
theatre times. Theatre utilisation was calculated as a
percentage of total scheduled theatre time used by

operative time. This audit aimed to assess the utili-
sation of plastic surgery theatres in one NHS hospi-
tal. In this study, the overall theatre utilisation rate

was 76.7% with 7.5% of time lost due to late starts

(median 20 minutes), 6.5% of time was used for pa-
tient turnover (median 14 minutes) and 12.1% of

time was wasted by early finishes (median 36 min-
utes). Theatre utilisation in this study is below the

recommended level. Recommendations: 1. Aim to
perform the ‘huddle’ in theatre half an hour before
the list begins; 2. Communication of a 30-minute and
15-minute warning so patients can be sent for earlier

to decreased turnover time; 3. Re-audit after chang-
es have been made. If start times and turnover times

are improved, there is the potential to add extra pa-
tients to theatre lists, increasing theatre utilisation.

Nature works on some fundamental principles which
we consider as nature’s norms and which have been

functioning since its creation. Biodegradation of ma-
terials is the norm of the nature or is called recycling

of its basic elements. All natural and biological fuels,

animals and plants remains, end up converted into
simple compounds and elements to be used up again
as natural resources. Human made materials though
helped in bringing a revolution in humans lives by
providing easily available, abundant, cheap and light

weight materials manufactured from easily repro-
ducible and readily available chemicals thus shifting

a complete dependence on these non-natural re-
sources. But in the long term that shifts proved costly

to the environment, humans and other living being’s

health. As these are human made synthetic materi-
al have been disturbing the fine balance maintained

by nature to dispose of the residual waste. Plastic is
one of the major and most important chemical that
shaped our lives in the last century until today but
unfortunately at the expense of natural balance.
Today most of the plastic products are completely
bio-ungradable. While improving our life styles by
using this cheap readily available material we are
advertently fighting against nature’s norms. We as
humans have damaged our environment more than
we can imagine. When this earth was handed over

to us it was plastic free. We have done all this for dif-
ferent reasons, which are all linked with our life style

and habits. Use of plastic in the shape of plastic bags,
plastic toys and lifesaving medical instruments etc is
now our nature. As plastics are not biodegradable
and due to extensive use plastics is one of the major

threats to our environment. The word plastic is de-
rived from the Greek πλαστικός (plastikos) meaning

“capable of being shaped or molded” and, in turn,

from πλαστός (plastos) meaning “molded”[1,2]. Plas-
tic is not new to our world, it existed in nature form

even before we invented it, and rather idea of plas-
tic came from nature itself. Early plastic was bio-de-