Background and Importance Since 2022 within our healthcare establishment, a multi-professional think tank has been engaged in the implementation of a sustainable development approach with three objectives: reduction of the volume of waste, energy saving and fight against pollution in the operating room (OR).

Aim and Objectives Rationalise Medical Device (MD) references and move some defined as uncritical in terms of infectious risk, sterile single-use double packaging, towards reusable ‘resterilisable’. The approach was applied to skin preparation sets, electric and cold scalpel handles.

Material and Methods A working group was created, made up of pharmacists, pharmacy technicians, OR managers, OR nurses, sterilisation and hygiene service. The number of references, quantities ordered, and the annual budget spent in 2022 were evaluated. For the skin preparation sets, an audit among OR nurses was carried out to assess usage practices and to find out if switching to re-sterilisable MDs for the skin preparation stage was possible. The organisational, economic and environmental impact was assessed.

Results In 2022, 15,690 skin preparation sets (€70,547), 15,455 single-use electric scalpel handles (€24,092) and 12,310 single-use cold scalpel handles (€2,050) were used. For the skin preparation sets, two of the three available references include a detersion set. The working group decided to remove them, to reference a double-packaged sponge stick and to integrate re-sterilisable cups into the instrumentation boxes (75% were in favour). An update of the procedures concerning skin preparation for the operation has been carried out. To integrate: one cup, one electric scalpel handle and two cold resterilisable scalpel handles, 684 instrumentation boxes were identified. The cost of purchasing MDs represents an investment of €27,600. That of sterilisation remains zero since these boxes are already in circulation. Finally, the estimated gain for the BO at the end of the first year is €43,000, i.e. a reduction in CO2 emissions of 13,545 kg.

Conclusion and Relevance This approach has been validated and has been in place since June 2023 with evaluation planned for the end of 2023. Other actions related to the reduction of waste at the OR are in progress, with a reflection on the double packaging of certain MDs.

Conflict of Interest No conflict of interest.