AST Guideline - Environmental Practices in the Operating Room

9 into consideration is the environmental impact of laundering operations including water and energy efficiency and use of environmentally friendly laundry chemicals. 26 (3) The initial cost of purchasing reusable textiles is typically higher than the cost of a disposable; however, the cost analysis may reveal that after the initial investment the HDO, over a period of time, realizes a cost savings with the reuse of the textiles. 26 (4) The HDO should evaluate the steps in the supply chain for the process of ordering and delivering sterile disposable products as opposed to using a single-delivery provider for reusable products. Studies have found that the ordering and delivering of sterile disposable products has multiple handling steps that contribute to an increase in cost for the HDO. 26 (5) Waste disposal costs for single-use textiles and basins. B. One study showed that the use of reusable textiles in the OR contributes to a considerable decrease in environmental pollution as well as costs. 9, 32 (1) The study showed that reusable textiles cause less environmental pollution than disposable textiles across several spectrums of types of pollution including carcinogens, climate shift, land use, over-fertilization of waters via waste water entry, photochemical oxidation, solid waste and water consumption. 9 The environmental pollution is a combination of the generation of RMW due to the use of disposable textiles in the OR and the manufacturing processes. 9 (2) CSTs often cover the sterile disposable back table and Mayo stand covers with extra cloth towels to prevent strike-through and tears. The use of non-disposable surgical textiles that meet barrier performance standards are more resistant to strike-through and tears. C. It is recommended that central sterile supply departments in cooperation with surgery departments switch from the use of disposable instrument tray wraps (often referred to generically as “blue wraps”) to non-disposable wraps and/or switch to the use of as many rigid containers as possible (some instrument sets, such a microsurgical instrument sets, are not conducive to the use of rigid containers). 7, 8 (1) Disposable blue wraps significantly contribute to a large portion of surgical waste. 8 One hospital study found that blue wraps contributed up to 55% of the total volume of disposable plastic that were generated by the OR. 29 Blue wrap is made of the soft plastic material polypropylene or #5 plastic. 29 (2) The containers have an upfront cost that can be a significant investment for large HDO’s; however, the rigid containers can be reused continually, driving down the cost of blue wrap and the related waste disposal costs. 32 Additionally, there are several other cost-benefit factors the HDO should take into consideration including purchase cost of steam and gas indicator tape, and waste