Comparing the Waste and Environmental Impact of Blepharoplasty at an Office-based Operating Room Versus an Ambulatory Surgery Center in the United States.

[PURPOSE] The aim of the study was to evaluate the environmental impact of a blepharoplasty as performed by a single surgeon at an office-based operating room (OR) versus at an ambulatory surgery center.

[METHODS] We employed life cycle analyses on routine, uncomplicated bilateral upper lid blepharoplasties as performed by a single surgeon. Life cycle phases of production, use, and end-of-life treatment were included. Study boundaries encompassed all waste products exiting the OR in addition to utility energy and water use. We conducted waste audits to collect data on surgical waste by item, material, and weight. Building energy and water use were approximated using data obtained from utility companies. Environmental impact is reported as global warming potential (GW100a; kg carbon dioxide equivalents).

[RESULTS] The office-based OR generated 784 g of physical waste per blepharoplasty as compared to 1323 g at the ambulatory surgery center. The life cycle analyses found that a blepharoplasty contributed a total of 6.42 kg carbon dioxide equivalents at the office-based OR and 7.78 at the ambulatory surgery center. The production phase contributed the majority of these carbon dioxide equivalents. Plastic supplies contributed the most waste by weight and emissions associated with production. Nonwoven polypropylene contributed the largest waste and emissions by material.

[CONCLUSION] The ambulatory surgery center produces more waste and carbon dioxide equivalents per blepharoplasty than the office-based OR. Use of supplies including drapes and gowns made of nonwoven polypropylene can be reduced to increase the environmental sustainability of blepharoplasty.