Sustainable healthcare
End of the line for disposable textiles?
Roberta Charlett examines the case for switching to reusable surgical textiles and the steps that will be required to successfully implement this.
The surgical textiles market has evolved significantly over the last two decades. Advances in technology and the introduction of highly engineered fabrics now mean that many of today’s reusable surgical textiles outperform disposable counterparts in terms of quality, fabric resistance and linting. However, we have also seen an increasing reliance on single-use equipment, with this thought to be responsible for up to 70 per cent of the carbon footprint of operating procedures. Until recently, many of these disposable plastics have been regarded as necessary due to the fact they allow for easy maintenance of a sterile healthcare environment. With concerns around sustainability and the urgent need to reduce the reliance on such items, if the NHS is to achieve its zero carbon emissions, it is now essential that Trusts work together to adopt strategies to eliminate the use of such disposable products wherever possible and practical.
The disposable myth Reusable surgical textiles provide an opportunity for the NHS to deliver significant carbon savings but, despite this, the use of disposable gowns and other items – such as drapes and tray wraps – is still prevalent within many operating theatres. There are a number of factors behind this, including the outdated view of some healthcare professionals that disposable perioperative textiles offer superior protection. Studies into the liquid and bacterial
penetration and infection risk of reusable and disposable products carried out over 20 years ago1
now have limited relevance to today’s
perioperative textiles, with earlier but frequently cited studies2
comparing materials now considered obsolete, such as cotton/polyester,
muslin and pulp. These older studies no longer apply to current reusable surgical textiles, and even some of the more recent reviews into the performance of reusable textiles compared to disposable counterparts fail to recognise the technological advancements in fabrics and the introduction of EU standards for surgical textiles – instead continuing to focus on earlier studies to support the use of disposable fabrics over reusable alternatives.3
Contemporary perioperative textile comparisons A 2012 comparison of reusable and disposable perioperative textiles by Michael Overcash4
gowns and drapes) reflect major changes in the technologies to produce and reuse these products’. The same article also states: ‘In multiple
science-based life cycle environmental studies, reusable surgical gowns and drapes demonstrate substantial sustainability benefits over the same disposable product…evidence- based comparison of environmental factors supports the conclusion that reusable gowns and drapes offer substantial sustainability improvements’. Overcash also co-authored a later study funded by the American Reusable Textile Association (ARTA).5
Published in 2018, does, however, acknowledge that
‘contemporary comparisons of reusable and disposable perioperative textiles (surgical
Clinical staff will need to develop the skills to be able to advance and engage with the digital agenda – ultimately, digitisation is as much about people as it is about technology.
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www.clinicalservicesjournal.com I February 2023
‘Environmental considerations in the selection of isolation gowns: A life cycle assessment of reusable and disposable alternatives’ compared the environmental impacts of 1,000 uses of reusable and disposable isolation gown systems using standard life cycle assessment procedures. The scope included the manufacture, use and end-of-life stages of the gown systems, and concluded that: ‘At the healthcare facility, compared to the disposable gown system, the reusable gown system showed
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