Rethinking sterile packaging practices for reusable medical equipment

This narrative review explores sterile packaging systems used for the storage of reusable medical devices, comparing their ability to maintain sterility, cost-effectiveness, resilience (of supply chains), and environmental impact. Operating theatres represent a significant portion of healthcare's waste and carbon footprint, with sterile packaging practices being a modifiable source of both economic and environmental burden. Existing evidence including life-cycle assessments and economic analyses indicates that reusable systems (i.e. rigid sterilization containers (RSCs) or reusable textile wraps) offer reductions in carbon footprint, waste, and long-term financial costs without compromising patient safety. Despite these advantages, single-use plastic (polypropylene) wrap ('blue wrap') anecdotally remains the predominant form of sterile barrier system in Australia due to convenience, fewer infrastructure requirements, and presumed lowered infection risks. Reusable textile wrap represents a historically validated system that combines the practical advantages of single-use plastic wrap with the economic and environmental benefits of reusable systems. Modern reusable textiles (e.g. polyester or polyurethane-coated fabrics) retain acceptable barrier properties over multiple reprocessing cycles, suggesting a practical middle ground between single-use plastic wrap and RSCs. Addressing these barriers and aligning regulatory frameworks with existing evidence could enable more sustainable sterile packaging practices in operating theatres.