Evidence-based Integration of Environmental Sustainability into Clinical Guidelines for Operating Rooms: A Systematic...

Area of Science:

• Environmental Science
• Healthcare Management
• Surgical Innovation

Background:

• Surgical practices significantly impact healthcare's environmental footprint.
• Limited guidance exists for integrating environmental sustainability into clinical recommendations.
• Evidence-based clinical guidelines can promote environmentally responsible surgical decision-making.

Purpose of the Study:

• To evaluate the feasibility of incorporating environmental sustainability into operating room (OR) clinical guidelines.
• To provide evidence-based recommendations for sustainable OR practices.
• To identify key areas within ORs that contribute to environmental impact.

Main Methods:

• A systematic review of 42 studies on OR environmental impact was conducted.
• Life Cycle Assessment (LCA) methods were utilized in 28 of the included studies.
• The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was applied to assess evidence quality and formulate recommendations.

Main Results:

• Key contributors to OR environmental impact include energy-intensive surgical technologies, disposable devices, anesthetic gas emissions, and ventilation energy consumption.
• The quality of evidence ranged from 'very low' to 'low' across studies.
• Life Cycle Assessment (LCA) studies were crucial in pinpointing environmental 'hotspots' for targeted interventions.

Conclusions:

• Environmental outcomes from OR studies consistently indicate areas for improvement, despite low evidence quality.
• Integrating Life Cycle Assessment (LCA) findings into clinical guidelines is vital for advancing surgical sustainability.
• Developing evidence-based recommendations can guide guideline panels toward promoting environmentally responsible surgical practices.