• Camila R Guetter, Barbara J Williams, Eliza Slama, Amanda Arrington, Marion C Henry, Mecker G Möller, Janet Elizabeth Tuttle-Newhall, Sharon Stein, and Marie Crandall.
• Universidade Federal do Paraná, Curitiba, Brazil.
• Am. J. Surg. 2018 Oct 1; 216 (4): 683-688.

BackgroundClimate change will affect most populations in the next decades and put the health of billions of people at risk. Health care facilities represent a significant source of pollution around the world and contribute to environmental changes. To address this topic, we performed a review of the available literature on tactics to reduce operating room (OR) waste and the potential of these strategies to impact the environment.Data SourcesA literature search was performed querying PubMed, Web of Science, and Science Direct. No comparative data were found; most were opinion papers, white papers, and case studies. For this reason, we proceeded with a narrative review, which provides an overview of the evidence on this topic and identifies areas for future research.ResultsThis systematic review summarizes the available literature on the 5 "Rs" of waste management: reduction, reusing, recycling, rethinking, and renewable energies.ConclusionsSurgery has a unique opportunity to transition to more environmentally-friendly operating room strategies, which may help decrease waste and lessen the impact of climate change.Copyright © 2018 Elsevier Inc. All rights reserved.

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