In the past, it was common practice to get rid of anything that was used - and unused - in operating rooms, but with rising health care costs due to government insurance and growing realization that many countries have few supplies at all, recovery of unused operating room materials has gotten new life.

Johns Hopkins University School of Medicine reported during the 2014 Clinical Congress of the American College of Surgeons that recovery of unused medical supplies from operating rooms for donation to surgical centers in developing countries can potentially alleviate a significant global burden of surgical diseases. 

In 1991, the Supporting Hospitals Abroad with Resources and Equipment (SHARE) program was started at Johns Hopkins with the assistance of Richard J. Redett III, MD, FACS, a study coauthor and director of pediatric plastic and reconstructive surgery, Johns Hopkins Cleft Lip and Palate Center. The program, which is student-run, works to recover unused medical supplies from ORs to send to developing countries.

Through SHARE, the authors studied the health benefits attributable to the donated supplies at recipient institutions, and conducted a pilot study by partnering with two tertiary-care centers in Guayaquil, Ecuador: Luis Vernaza Hospital and Damien House Organization.

Although it is not new that ORs in the US generate excess unused supplies, there has not been a systemization of gathering data on the amount of supplies that are recoverable, and the possibilities they hold for donation to developing countries, the authors said. Therefore, the Johns Hopkins researchers are working toward improving this aspect of the field through their study.

"Hospital administration and staff can actually get feedback on their policies and practices using programs such as ours, because we collect and generate quite a bit of data," said Eric L. Wan, a study coauthor, and post-baccalaureate Intramural Research Training Award Fellow at the National Institutes of Health.

In ORs throughout the U.S., surgical supplies are often packaged together. Upon being opened, there are commonly excess supplies that remain unused. "Everything we recover is unused. When you open up a kit for surgery in the OR, you very frequently have many supplies that you won't use. Those items typically are taken off of the back table before the incision is made, so they're completely sterile and unused," Dr. Redett said.

SHARE has developed a program to place bins in ORs where unused and sterile supplies can be placed for recovery and delivery to surgical centers in developing countries. Through their work in studying the trend of excess unused medical supplies in ORs, the study authors analyzed donated supplies over a three-year period by quantity and weight, and estimated the value the supplies would have if the program were to be implemented nationwide.

They found that approximately two million pounds of recoverable medical supplies exist each year in nonrural, large US academic medical centers. These donations collectively hold a potential worth of at least $15 million per year.

The materials collected for donation range from gowns to catheters. However, Mr. Wan said that they don't simply send anything they recover to the recipient centers. "The things that we collect may differ from the things that we send out, only in that we don't like to send out supplies that they're not going to use, and generate waste for them locally," he said. "We do work with surgery centers abroad to identify what they need, so that we can more accurately and efficiently send them the materials without generating waste for them."

While recovery programs like SHARE have the ability to help alleviate the global burden of surgical disease by donating supplies to surgery centers in developing countries, there are also strong implications for ORs in the US to reduce their environmental impact domestically. "I think reducing waste is something in the U.S. that we'll probably get better at...but there is still a lot of medical supply waste generated in the operating room," Dr. Redett said.

In looking to the future of the SHARE program and our domestic ability to recover supplies in the OR, Mr. Wan said, "We are always hoping to expand. One could dream that every hospital has a program like this and forms community partnerships that are both local and global, so that these supplies don't become labeled as waste and instead become labeled as a resource that can be shared."