A comparative life cycle assessment of the environmental impact of preoperative skin preparation, single-use applicators versus bulk antiseptic with reusable instruments

Background Preoperative skin preparation (PSP) is a critical step of surgery to reduce bacteria on the skin that can cause infections. It is commonly believed that the reusable equipment method of PSP reduces environmental emissions relative to single-use options. However, no research comparing entire-life cycle environmental emissions associated with the two approaches exists. Methods A Life Cycle Assessment (LCA) was conducted comparing PSP in a European hospital using a single-use applicator versus a reusable equipment method. Results Findings highlight the superior environmental performance of a single-use antiseptic applicator method, resulting in 49% less CO 2 -eq emissions than the reusable method. Similar trends were observed across all categories: climate change, cumulative energy demand, water scarcity, resources, ecosystems, and human health. The single-use applicator had lower energy demand and higher resource efficiency. In addition, the single-use applicator was less sensitive to hospital and staff practice variability. Discussion The study challenges the assumption that reusable systems always result in lower environmental impacts. This LCA revealed that efficient manufacturing processes, optimized use of antiseptic during procedure, and reduced energy consumption throughout the single-use method life cycle can decrease the carbon footprint. This highlights the need to scrutinize the life cycle when making comparisons as part of surgical sustainability.