Sofia Baldelli
Introduction
The NHS has pledged to become net-zero by 2040. One of the suggestions proposed by this pledge is the adoption of PPE with a superior sustainability profile. Within the operating theatre, both disposable and reusable gowns and drapes are used but there is currently no clear consensus on which is better in terms of environmental, fiscal or performance outcomes. In this systematic review we compare reusable versus disposable items in all three measures.
Methods
Eligible studies were those comparing single-use and reusable surgical gowns and drapes in operating theatres, including experimental designs (randomized controlled trials, non-randomized trials, cohort studies), and systematic reviews. Studies focused on environmental, fiscal, or performance outcomes were included, while those without an English full-text version were excluded. Searches were conducted in Cochrane Central, MEDLINE, and EMBASE, including grey literature and relevant textile industry publications. The Newcastle Ottawa Scale was used to assess risk of bias.
Results
The review included 13 studies. Reusable gowns and drapes consistently demonstrated reduced environmental impacts, including lower energy consumption, greenhouse gas emissions, water usage, and waste generation. Cost-effectiveness analyses favored reusables, highlighting long-term savings and increased supply chain resilience. Reusable gowns offered superior protection and durability, although single-use gowns were occasionally preferred for comfort.
Conclusions
This systematic review shows that there are strong environmental and economic benefits of reusables, but a key limitation is variability in comfort. Reusable gowns and drapes are recommended as a sustainable alternative to single-use items, aligning clinical practice with environmental and economic goals.
Authors
Sofia Baldelli
University Hospitals Sussex, Brighton, United Kingdom
Frank Davis
University Hospitals Sussex, Brighton, United Kingdom
Niall Hill
Cardiff Medical School, Cardiff, United Kingdom
Mahmood Bhutta
University Hospitals Sussex, Brighton, United Kingdom