Cut the wrap: How to reduce hospital waste and emissions

On average, Saint Marys Hospital at the Mayo Clinic in Rochester, Minn., produces six compactor loads of waste per day, all of which have to be hauled to an incineration facility for disposal. “This is a huge volume of material being generated across the facility, much of it as a single-use waste stream from our sterilization processes,” says Kevin Hovde, operations manager of hospital surgical services.

It’s not alone: Sterilization wrap makes up as much as 20 percent of the surgical services waste stream and 5 percent of the total waste stream in some medium to large hospitals, according to a University of Minnesota Medical Center fact sheet. Health care facilities often use sterilization wrap -- also called disposable surgical wrap or blue wrap -- to wrap surgical instruments during sterilization, a critical procedure to help minimize patient infections during surgery. The disposable sheets made of nonwoven polypropylene, an inert polymer derived from petrochemicals, allow the sterilant -- usually steam -- to penetrate and sterilize the instruments. That steam, in turn, causes structural changes to the wrap that prevent the entry of microbes and contamination after sterilization, while the instruments are being stored.

Health care facilities also have a second option: A reusable hard case often made of aluminum. These hard boxes also have a small piece of nonwoven polypropylene to allow the sterilant in. That small piece, which makes up a fraction of the weight of a full blue-wrap sheet, still needs to be replaced every time the box is used. Like the disposable wrap, the hard case also maintains the sterility of the tools until they’re used.

Either way, the sterilization process costs health care facilities considerable annual expense. There’s the ongoing purchase of the single-use wrap or the high initial cost of the reusable sterilization cases. Handling and storage requirements also can deter some facilities from opting for the cases.

Single Use Equals Big Impact

Last year, the Minnesota Technical Assistance Program, or MnTAP, partnered with researchers at the University of Minnesota’s bioproducts and biosystems engineering department -- as well as a surgical services division at the Mayo Clinic -- to assess the lifecycle environmental impact of both reusable cases and disposable wrap at the Mayo Clinic.

The results from this comprehensive analysis indicate that reusable sterilization containers yield significant environmental advantages over disposable sterilization wrappings. Instrument sterilization using reusable cases emits roughly half the greenhouse gas emissions of using disposable wrap, while generating just 12 percent of the solid waste, even when only the first year of use is considered.

Next page: Could new data tip the balance in favor of hard cases?