REVERSE LOGISTICS OF SURGICAL EXPLANT IN A PHILANTHROPIC HOSPITAL: IMPLEMENTATION OF A NEW ECOEFFICIENT MODEL OF MANAGEMENT HOSPITAL WASTE/LOGISTICA REVERSA DE EXPLANTES CIRURGICOS EM UM HOSPITAL FILANTROPICO: IMPLANTACAO DE UM NOVO MODELO ECOEFICIENTE DE GERENCIAMENTO DE RESIDUO HOSPITALAR

Surgical explants are metal devices that had been implanted surgically implanted and and that after withdrawal from patients follow a differentiated destination of the other hospital waste, since they must be submitted to the sterilization process to be considered no biological risk waste. The present study aimed to implement a system for the management of the waste disposal from surgical explants, after a diagnosis made using the Environmental Management Accounting (EMA) System evaluation tool, considering the preparation stages of the materials, from the generation of the waste to its final disposal. For the implementation of the management system, tools were used to control, to prepare the flow, and to train employees, whose methods were prepared jointly with those responsible for the technical areas involved and, finally, after the explant was considered useless, it was sent to a company specializing in the treatment of explants, for the reverse manufacturing. Future studies should be made to extend the analysis to other health care facilities, as well as conduct a more in-depth analysis of the eco-efficiency of the hospital process. With the measures implemented, it was seen that there was a 45% increase to 100% of the eco-efficiency in operations related to the destination of this type of waste, because of the management of disposal and application of reverse manufacturing. Keywords: Surgical Explants; Reverse Manufacture; Residues; EMA; Eco-efficiency; Sustainability. Explantes cirurgicos sao dispositivos metalicos que foram implantados cirurgicamente em pacientes e que depois de retirados seguem uma destinacao diferenciada dos demais residuos hospitalares, ja que devem ser submetidos ao processo de esterilizacao para serem considerados residuos sem risco biologico. O presente estudo teve como objetivo implantar um sistema de gerenciamento de descarte de explantes cirurgicos, apos um diagnostico realizado por meio do uso parcial da ferramenta de avaliacao o Sistema Contabil Gerencial Ambiental (SICOGEA), considerando as etapas de preparacao dos materiais, desde a geracao do residuo ate sua disposicao final. Para a implantacao do sistema de gerenciamento foram aplicadas ferramentas de controle, elaboracao de fluxo e capacitacao dos funcionarios, cujos metodos foram preparados em conjunto com os responsaveis pelas as areas tecnicas envolvidas e, por fim, apos o explante ser considerado residuo inservivel e encaminhado a uma empresa especializada no tr