Environmental benefits of reintroducing reusable drapes and gowns in the operating room.

BACKGROUND: The healthcare sector contributes significantly to environmental pollution, which adversely affects human health. Operating rooms are a major source of this impact, partially due to the routine use of disposable materials prepacked in surgical trays. The main objective of this study was to compare the environmental impacts of fully disposable surgical trays with those of hybrid surgical trays, which replace disposable drapes and gowns with reusable ones. METHODS: This multicentre study included surgical trays from three types of surgeries: gynaecological laparoscopy surgery, extremity surgery, and caesarean section. This selection captures a broad range of surgical workflows and instrument requirements, enabling the development of an average tray composition and enhancing the generalizability of the findings across various surgical specialties. The hybrid trays, including reusable drapes and gowns, were developed and tested specifically for this study. A life cycle assessment was conducted according to ISO 14040/44 standards to compare the environmental impacts of the hybrid and disposable trays across 18 impact categories. RESULTS: Hybrid trays demonstrated lower environmental impacts than disposable trays across almost all impact categories. For climate change, hybrid trays reduced impact by 40-51%. In disposable trays, drapes and gowns contributed to approximately 69% of the total climate change impact, whereas in hybrid trays this contribution decreased to 38%, primarily because the production and end-of-life impacts of reusable drapes and gowns are distributed over multiple uses. CONCLUSION: These results provide a robust evidence base to inform and support a broader European Union-wide transition to hybrid trays, incorporating reusable drapes and gowns, in operating rooms.