Human and veterinary healthcare has a significant environmental impact (Guetter et al., 2018), with a large volume of waste generated in the operating theatre. Whilst there has been a tendency towards single-use items such as gowns and drapes for the purposes of infection control and convenience, the use of these items comes at an environmental cost. Not only is there a larger carbon footprint associated with production and disposal of these items, incineration of medical plastics is a leading cause of harmful toxic emissions such as dioxins. A sensible and risk-based approach can help reduce the waste generated. Here are some suggestions of simple switches to get started:
1) Consider reusable surgical gowns
Even accounting for the water and energy required for production and laundering, various studies have found that the use of reusable surgical gowns significantly reduces energy consumption, greenhouse gas emissions, blue water consumption and solid waste generation when compared to single-use items (Vozzola, Overcash and Griffing, 2018; Burguburu et al., 2022). Although the barrier properties of these materials makes them unsuitable for procedures in which there is significant wetting of the fabric (Belkin, 2002), a risk-based approach may easily be applied to their use in certain procedures. The use of these reusable surgical textiles also contributes to greater business resilience, reducing the reliance on a constant supply of single-use textiles.
2) Make use of reusable fabric drapes and foot covers
While the jury is still out on whether synthetic drapes are superior to woven drapes in terms of surgical site infection risk (Vasanthakumar, 2019), reusable drapes may be used according to a similar risk-based approach. For example, these are ideally suited for drapes to cover the feet in order to reduce environmental contamination in theatre. Companies including Burlington produce barrier fabrics which retain their water-repellent properties for up to 100 washes.
3) Switch from using single-use incontinence pads to washable cotton towels
These commonly-used items often end up as an expensive, and carbon-intensive, source of clinical waste. If possible, use cotton towels instead, and reduce the use of textiles to avoid excess energy (and financial) costs associated with laundering.
4) Switch from single-use autoclave pouches to reusable sterilising tins
These reusable sterilisation containers have been available for some time, and are becoming ever more popular. A number of companies produce a range of products. For a start, take a look at the following:
• https://www.freelance-veterinary.co.uk/instruments/ophthalmic-instruments/sterilisation-cases
• https://keysurgical.co.uk/products/cssd/sterilisation-trays-and-accessories
• https://www.bbraun.co.uk/en/products-and-therapies/services/sterile-supply.html
There is also a booming second-hand market in these containers!
5) Use easily disinfected, designated theatre shoes rather than relying on overshoes
6) Consider switching from disposable to reusable cotton scrub caps. A large number of producers have cropped up recently, and a huge range of designs are available. For inspiration, see AllScruppedUpScrubHats and ScrubdUp.
7) Consider installing a distilled water machine, rather than relying on bottled distilled water. Not only does this vastly reduce the number of plastic bottles involved, it makes economic sense, with significant savings in the long term.Hopefully that provides a little inspiration to get started. For more information, click here.
If you have any further ideas or comments, we would love to hear from you at sustainability@beva.org.uk