Staff Perspectives of Single-use versus Reusable Sterile Textiles: A Qualitative Analysis

INTRODUCTION: Operating theaters contribute significantly to healthcare-related carbon emissions, with single-use surgical textiles being a key contributor. Reusable sterile surgical textiles are available, yet their adoption is not widespread. This study explored the views of hospital staff, including surgeons and those working in procurement, of single-use and reusable sterile textiles. METHOD: This qualitative analysis was conducted in one National Health Service trust in England. Fourteen hospital staff were recruited either via self-selection or purposive sampling to ensure representation of key stakeholders. The semistructured one-to-one interviews were imported into NVivo software and analyzed using thematic analysis. RESULTS: Six themes were developed: (1) current practice, (2) practical considerations, (3) infection prevention concerns, (4) social norms, (5) levers for change, and (6) navigating complex systems. Continued use of single-use surgical textiles was driven by complex procurement systems, convenience, perceived cost, and embedded practices. The transition to reusable sterile textiles was hindered by existing surgical culture, personal preferences and by those in "green" roles experiencing a lack of time, agency, and resource to enact change. A key barrier was a perception that reusable textiles increased infection risk, especially in the orthopedic specialty. CONCLUSIONS: Despite no evidence that single-use surgical textiles offer superior patient protection, the adoption of reusable textiles is constrained by engrained practices and misconceptions. Broader dissemination of lifecycle analysis evidence, coupled with messaging cascaded via national guidance, royal colleges, and local leadership could support both individual and system-wide acceptance of reusable surgical textiles.