How Sustainable Are Reusable Surgical Textiles? What the Evidence Says

Reusable surgical textiles can have a smaller environmental footprint than single-use ones, but only when they are used many times and laundered efficiently. Life cycle studies comparing reusable and disposable surgical gowns have generally favoured reusables on energy, emissions, water and waste, though several of the best-known studies were sponsored by the reusable textile industry and their results depend heavily on assumptions. For a hospital, the honest answer is that sustainability comes from how reusables are managed, not from the word "reusable" itself.

This post looks at what the evidence says, where the environmental costs of reusable theatre textiles actually sit, and what a hospital can do to make the most of them.

What life cycle studies look at

A life cycle assessment (LCA) tries to count the environmental impact of a product from raw materials to disposal. For surgical gowns and drapes, that typically includes:

• Growing or producing the fibres and making the fabric
• Manufacturing the gown or drape
• Transport at each stage
• For reusables: every laundering and sterilisation cycle, including water, energy, chemicals and wastewater treatment
• For disposables: making a new item for every use
• End of life: landfill, incineration or other disposal

The results depend on choices made in the study: how many times a reusable is assumed to be used, how efficient the laundry is, how electricity is generated, and how far items travel.

What one widely cited study found

One frequently quoted LCA, initiated by the American Reusable Textile Association (ARTA) and the International Association for Healthcare Textile Management (IAHTM) and published in the AORN Journal in 2020, compared reusable and disposable surgical gowns across their life cycles, including laundering and wastewater treatment. As summarised by the cleaning industry publication CINET, it reported that reusable gowns had:

Measure	Reported difference for reusable gowns
Energy consumption	64% lower
Greenhouse gas emissions	66% lower
Blue water consumption	83% lower
Solid waste generation	84% lower

Two cautions apply. First, the study was initiated by reusable textile industry associations, so it should be read with that interest in mind. Second, other summaries of the same work report slightly different figures for some measures, and LCA results always depend on their assumptions. Treat these numbers as a sign of direction, not a figure to put in your own sustainability report without checking the original paper and its assumptions.

Where the environmental cost of reusables sits

For reusable theatre textiles, most of the impact is in use rather than in manufacture. Every cycle uses water, energy and chemicals, and every cycle involves transport. That means the operational choices a hospital and its laundry make have a large effect.

Number of uses

The more times an item is used before it is retired, the more the impact of making it is spread out. Items that are lost, damaged early or retired at inspection reduce the benefit. Tracking and good inspection, covered in our guide to how many times surgical gowns can be reused, are sustainability measures as well as safety ones.

Laundry efficiency

Laundries differ widely. Some recycle rinse water and recover heat from wastewater; others run older or under-loaded machines that use much more per kilogram of linen. Ask your laundry provider, in-house or outsourced, about:

• Water use per kilogram of linen
• Energy sources and heat recovery
• Chemical dosing and wastewater treatment
• Machine loading and scheduling

Transport

Linen travels between theatre, laundry and CSSD every cycle. Long or frequent journeys add up. Planning collections and deliveries well, and using a laundry close to the hospital where possible, reduces this.

Item size and weight

Larger, heavier items use more water, energy and chemicals per cycle. Drapes that are bigger than needed carry that extra cost every time they are processed. Sizing drapes to tables and procedures is a quiet but real sustainability win.

Manufacture and shipping

Making reusable textiles does have an impact, as does shipping them. These are one-off costs per item, spread across every use. Fewer, longer-lasting items reduce them; frequent emergency reorders of short-lived items increase them.

Practical steps for a more sustainable reusable programme

1. Set and follow a reuse limit so items are neither retired too early nor kept too long.
2. Cut losses with clear collection, marking and stock counts.
3. Size items correctly, so drapes and covers are no larger than needed.
4. Review pack contents, removing items that are routinely sent back unused but still processed.
5. Work with your laundry on water, energy and chemical use, and ask for data.
6. Choose durable fabrics and construction suited to your laundry process.
7. Repair where policy allows, to extend useful life outside critical zones.
8. Plan orders, so replacements arrive in fewer, consolidated shipments.

Measuring your own programme

Published studies tell you about someone else's laundry and someone else's assumptions. If sustainability is a goal, measure your own programme, even roughly:

• Kilograms of theatre linen processed per month, from the laundry
• Water and energy per kilogram, if the laundry can report it
• Number of items retired each month, and why
• Number of items lost
• Volume of single-use theatre items still being bought alongside reusables

Tracked over a year, these figures show whether changes such as better loss control or smaller drapes are actually making a difference. They also give you real numbers to use in internal reports, which are far more defensible than percentages borrowed from a study done elsewhere.

Checking sustainability claims

Suppliers of both reusable and disposable products make environmental claims. Before using any claim in a tender evaluation or report:

• Ask for the full study, not a summary or press release.
• Check who funded it and whether it was peer reviewed.
• Check the assumptions: number of uses, laundry process, energy mix, transport distances.
• Ask whether the conditions match yours, including how your laundry and CSSD actually run.
• Be wary of vague words like "eco-friendly" or "green" without supporting data.

The same scrutiny applies to any claims made about your own programme. If your hospital reports savings, base them on your own data where you can.

Sustainability is not the only test

Environmental benefit has to sit alongside clinical requirements. Your infection-control team decides which textiles meet the barrier performance needed for each procedure, and reusable woven textiles should not be treated as certified barrier products unless the supplier documents what they are tested to. Our posts on reusable vs disposable surgical gowns and low-lint theatre textiles cover other factors in the decision.

Checklist

• Evidence read in full, with funding and assumptions checked
• Reuse limits set and cycles tracked
• Losses and early retirements monitored
• Laundry asked for water, energy and chemical data
• Drape and pack sizes reviewed
• Durable fabric and consistent specification for reorders

MISHAREN makes reusable surgeon gowns, drapes, covers and wrapping cloths at its own production unit in Konni, Kerala, then ships them to the UAE for delivery across all seven emirates. If a longer-lasting reusable set is part of your plan, visit the OT gowns and drapes page or contact us for a quotation.