Modeling life cycle analysis of eco-designed practices in arthroscopic rotator cuff repair: a pilot study

Q2 Medicine

JSES International Pub Date : 2025-09-01 DOI:10.1016/j.jseint.2025.04.009

Charlotte Martin MD , Cléa Ohannessian MD , Fabrice Ferré MD, PhD , Fanny Vardon MD, PhD , Nicolas Bonnevialle MD, PhD , Vincent Minville MD, PhD

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Abstract

Background

Climate change represents a critical public health challenge, with health-care systems contributing 5.5%-8% of global greenhouse gas emissions.

Methods

This pilot study assessed the environmental impact of arthroscopic rotator cuff repair, a common surgical procedure, and evaluates the potential of eco-designed care practices to reduce this impact. Environmental impact was evaluated through life cycle analysis using the ReCIPE method, measuring CO2 production and 11 other environmental indicators. Data collection included resource use, waste generation, and procedural details from representative surgeries. The model also implemented measures such as reusable surgical equipment, reduced halogenated anesthetics, optimized waste sorting, and locally produced, sustainable staff garments.

Results

Results showed a 54% reduction in CO2 emissions (109.2 kgCO2eq vs. 51.1 kgCO2eq) and significant improvements across all assessed environmental categories, including a 60% decrease in stratospheric ozone depletion and a 52% reduction in ozone formation. Each surgical phase demonstrated decreased environmental impact, particularly in waste management and anesthesia.

Conclusion

While limited by its single-center design, this study highlights the feasibility of integrating eco-design principles into health-care practices. These findings emphasize the importance of reducing the environmental footprint of surgical care, aligning with global sustainability goals. Future research should expand on these preliminary findings to develop standardized eco-design strategies in health-care systems.

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关节镜下肩袖修复中生态设计实践的建模生命周期分析：一项试点研究

气候变化是一项重大的公共卫生挑战，卫生保健系统的温室气体排放量占全球温室气体排放量的5.5%-8%。方法本初步研究评估了关节镜下肩袖修复（一种常见的外科手术）对环境的影响，并评估了生态设计护理实践的潜力，以减少这种影响。环境影响评价采用ReCIPE方法，通过生命周期分析，测量CO2产量和其他11个环境指标。数据收集包括代表性手术的资源使用、废物产生和手术细节。该模型还实施了可重复使用的手术设备、减少卤化麻醉剂、优化废物分类和当地生产的可持续工作人员服装等措施。结果显示，二氧化碳排放量减少了54%（109.2千克二氧化碳当量vs. 51.1千克二氧化碳当量），所有评估的环境类别都有显著改善，包括平流层臭氧消耗减少了60%，臭氧形成减少了52%。每个手术阶段对环境的影响都有所减少，特别是在废物处理和麻醉方面。结论受单中心设计的限制，本研究强调了将生态设计原则融入卫生保健实践的可行性。这些发现强调了减少外科护理的环境足迹的重要性，与全球可持续发展目标保持一致。未来的研究应在这些初步发现的基础上进行扩展，以便在卫生保健系统中制定标准化的生态设计策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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