[Contribution of medical devices to the carbon footprint of an ambulatory surgery unit: Current assessment and decarbonization perspectives].

Healthcare represents 8% of France's greenhouse gas (GHG) emissions. Medical devices procurement contributes for 30% of this footprint. Within our hospital group, carbon footprint (CF) assessment is being extended to several care pathways in ambulatory surgery units (ASU). This study aimed to quantify the ASU CF and identify the principal emission hotspots. A multidisciplinary team performed a two-week activity-based inventory in 2023. Data were converted to CO2e using appropriate emission factors. The assessment covered water, energy, patient and staff transportation, acquisition and maintenance of equipment (allocated to 2022 activity), pharmaceutical and medical supply procurement, and waste generation quantified by weighing. For 2022, total ASU CF were estimated at 684 tCO2e for 4,884 procedures, i.e., 140kgCO2e per operation. The main contributors were single-use sterile medical devices (SUUMD) (52%), equipment (15%), energy (6%), reusable sterilizable medical devices (6%), staff transportation (5%), pharmaceuticals (3%), patient transportation (2%), and waste (2%). Single-use sterile medical devices emerged as the main driver of ASU-related emissions. Current environmental actions (e.g., low-flow sevoflurane use and improved operating-room waste segregation) should be strengthened by targeted procurement strategies for single-use sterile medical devices to achieve further reductions.