Table 1.
Characteristics of included studies, and classification of interventions into five domains.
| Study | Study type | Country | Specialty | Study design and details | |
|---|---|---|---|---|---|
| 1. Reduce and rationalize | |||||
| Thiel et al., 201840 | Quantitative, prospective | U.S.A. | Obstetrics and Gynecology | 17 laparoscopic hysterectomy procedures. Quantitative prospective, single-centered study | |
| Thiel et al., 201921 | Quantitative, retrospective | U.S.A. | Orthoplastic Surgery | 178 small hand surgeries. 2 surgeons performing the surgery. Quantitative, retrospective, single-centered study | |
| Rizan et al., 202222 | Quantitative, prospective, audit data | U.K. | All | Evaluation of carbon footprint and financial cost of decontamination and packaging of reusable surgical instruments | |
| Wormer et al., 201320 | Longitudinal, observational, noncontrolled | U.S.A. | All | 17 000 inpatient surgeries. Measured over a year. One hundred consecutive physicians’, nurses’, residents’, and technicians’ scrub cycles. Quantitative, prospective, single-centered study | |
| 2. Reusable equipment and textiles | |||||
| McGain et al., 201229 | Quantitative, retrospective LCA | Australia | Anesthetic | LCA of one single-use and one reusable central venous catheter (CVC) kit. Quantitative, retrospective, single-centered study | |
| Eckelman et al., 201223 | Quantitative, retrospective LCA | U.S.A. | Anesthetic | LCA of 40 disposable laryngeal masked airways (LMAs) and 40 uses of 1 reusable LMA. Quantitative retrospective, single-centered study | |
| McGain et al., 201732 | Quantitative, retrospective LCA | Australia | Anesthetic | LCA of five scenarios of replacing reusable anesthetic equipment with single-use variants. Quantitative, retrospective, multicentered (two hospitals with six operating rooms) study | |
| Sherman et al., 201824 | Quantitative, retrospective LCA | U.S.A. | Anesthetic | LCA of one stainless steel reusable and two (one metal and one plastic) single-use device rigid laryngoscope handles and blade alternatives. Quantitative, retrospective, single-centered study | |
| Davis et al., 201831 | Quantitative, retrospective LCA | Australia | Urology | LCA of single-use digital flexible ureteroscope and Olympus Flexible Video Ureteroscope per case. Quantitative, retrospective, single-centered study | |
| Astroza et al., 202026 | Pre–post, noncontrolled, prospective study | Chile | Urology | Conference abstract of an evaluation of plastic waste reduction from intervention. Mixed methods: questionnaire (results not included) and quantitative, prospective, pre–post noncontrolled study | |
| Leiden et al., 202030 | Quantitative, retrospective LCA | Germany | Orthopedic Surgery | LCA of reusable or disposable instruments needed for one single-level lumbar fusion surgery. Quantitative, retrospective, single-centered study | |
| Jabouri and Abbott, 202227 | Quantitative, prospective | U.K. | Dermatology | Evaluation of the environmental impact of 62 packs (14 single-use and 48 reusable), reflecting an average weekly use. Quantitative, prospective, single-centered study | |
| Vozzola et al., 202025 | Quantitative, retrospective LCA | U.S.A. | All | LCA of 1000 uses of a gown in an OR setting. Examined 11 reusable and 7 disposable gowns. Quantitative, retrospective, single-centered study | |
| Rizan and Bhutta, 202228 | Quantitative, retrospective LCA | U.K. | General Surgery | LCA of equipment required for one laparoscopic cholecystectomy. Quantitative, retrospective, single-centered study | |
| Rizan et al., 202222 | Quantitative, prospective audit data | U.K. | All | Evaluation of carbon footprint and financial cost of decontamination and packaging of reusable surgical instruments | |
| 3. Recycle and waste segregation | |||||
| Debois et al., 201333 | Pre–post, noncontrolled, prospective study | U.S.A. | Cardiovascular | 400 consecutive cases. Quantitative, prospective, pre–post noncontrolled, single-centered study | |
| Wormer et al., 201320 | Quantitative, prospective | U.S.A. | All | 17 000 inpatient surgeries. Measured over a year. One hundred consecutive physicians’, nurses’, residents’, and technicians’ scrub cycles. Quantitative, prospective, single-centered study | |
| Thiel et al., 201840 | Quantitative, prospective | U.S.A. | Obstetrics and Gynecology | 17 laparoscopic hysterectomy procedures. Quantitative prospective, single-centered study | |
| 4. Anesthetic alternatives | |||||
| McGain et al., 202035 | Pre–post, noncontrolled, prospective study | Australia | Anesthetic | Ex-vivo modeling, simulation study. A simple lung model with fixed CO2 inflow. LCA. | |
| Thiel et al., 201840 | Quantitative, prospective | U.S.A. | Obstetrics and Gynecology | 17 laparoscopic hysterectomy procedures. Quantitative prospective, single-centered study | |
| McGain et al., 202135 | Quantitative, prospective | Australia | Anesthetic | LCA of all anesthesia needed for a total knee replacement, using general, spinal, or combined anesthesia. Twenty-nine patients. Quantitative prospective, single-centered study | |
| Griffin et al., 202234 | Conference abstract of a retrospective study | U.K. | Anesthetic | Conference abstract of a retrospective study | |
| 5. Other | |||||
| Moussa et al., 202236 | Quantitative, retrospective, continuous, comparative, multicenter trial | U.K. | Ophthalmology | 3239 rhegmatogenous retinal detachment procedures in three centers, over 4 years. Quantitative, retrospective, continuous, comparative multicenter trial | |
| Unger et al., 201737 | Quantitative, retrospective | U.S.A. | Obstetrics and Gynecology | LCA of all medical devices that contained petroleum-based plastics suitable for biopolymer substitution for a single hysterectomy, separated into laparoscopic, abdominal, vaginal, and robotic. Quantitative, retrospective, single-centered study | |
| Rizan et al., 202222 | Quantitative, prospective audit data | U.K. | All | Evaluation of carbon footprint and financial cost of decontamination and packaging of reusable surgical instruments | |
LCA, life cycle analysis; OR, operating room; U.K., United Kingdom; U.S.A., United State of America.