Life cycle assessment of a disposable and a reusable surgery instrument set for spinal fusion surgeries
Life cycle assessment of a disposable and a reusable surgery instrument set for spinal fusion surgeries
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DOI：
10.1016/j.resconrec.2020.104704
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发表时间：
2020-05-01
影响因子：
13.2
通讯作者：
Herrmann, Christoph
中科院分区：
文献类型：
--
作者：
Leiden, Alexander;Cerdas, Felipe;Herrmann, Christoph
全球财富的增加和人类预期寿命的延长导致医疗程序和手术数量的增加。手术是复杂的医疗程序，在医疗保健系统的总体环境影响中占很大一部分。在手术造成的环境影响的其他重要来源中，所需仪器造成的材料消耗占手术产生的温室气体排放量的 65%。本研究调查了用于腰椎融合手术的一次性和可重复使用的手术器械对环境的影响，以及哪种系统对环境更有利。对于腰椎融合手术，可重复使用和一次性的器械和植入物套件是可商业购买的。这两套装置都能够支持单级腰椎融合手术。可重复使用的套件在手术前是全面且完全打开的，而一次性系统则采用模块化盒系统，并且在手术期间按需打开盒子。为了比较这些不同配置的环境影响，进行了比较生命周期评估 (LCA)，以评估两种替代方案的总体环境影响。主要发现之一是，为可重复使用的仪器所选择的清洁和灭菌过程造成了高达 90% 的温室气体排放，并决定了哪种系统从环境角度来看是有利的。从环境角度来看，减少手术中需要清洁和消毒的器械数量应该是未来手术器械开发的重点。
The worldwide increasing wealth and increased life expectancy of humans has led to an increase in the number of medical procedures and surgeries. Surgeries are complex medical procedures which contribute to a significant share of the total environmental impact of the healthcare system. Among other important sources of environmental impacts from surgeries, material consumption due to required instrumentation accounts for up to 65 % of greenhouse gas emissions from surgeries. This study investigates how a disposable and a reusable surgery instrument sets for lumbar fusion surgeries contribute to the environmental impact and which system is more advantageous for the environment. For lumbar fusion surgeries, reusable and disposable instrumentation and implant sets are commercially available. Both sets are capable to support a one level lumbar fusion surgery. The reusable set is comprehensive and fully opened before the surgery, while the disposable system comes in a modular box system, and the boxes are opened on demand during the surgery. To compare the environmental impact of these different configurations, a comparative Life Cycle Assessment (LCA) was performed to assess the overall environmental impacts of both alternatives. One of the key findings is that the selected cleaning and sterilization process for reusable instruments is responsible for up to 90 % of the greenhouse gas emissions and decides which system is advantageous from an environmental perspective. Reducing the number of instruments to be cleaned and sterilized for a surgery should be the focus for future surgery instruments development from an environmental perspective.