Purpose In this article, we analyze how environmental aspects can be derived from life cycle management instruments for procurement decisions of low-value products. For our analysis, we chose the case of operating room textiles. The review includes the life cycle management instruments: life cycle assessment, environmental labels, and management systems applied within the textile industry. We do so in order to identify the most important environmental decision criteria based on which the procurer of low-value products can decide for the most environmentally friendly option. Methods We conducted a systematic literature search in the relevant literature databases. We critically evaluate the identified life cycle assessment studies for sound methodology, verifiability, completeness, and actuality. Based on this review, we analyze and compare the results of the three most comprehensive studies in more detail and derive the most important environmental aspects of operating room textiles. In a second step, we extend the operational perspective via the strategic perspective, namely environmental management systems and further existing life cycle instruments such as eco-labels. We then synthesize the gathered information into a decision vector. Finally, we discuss how the gathered data can be further exploited and give suggestions for a more sophisticated assessment. Results and discussion The review of the existing life cycle assessments on operating room textiles showed that procurers should not base their decisions exclusively on existing life cycle assessments. In addition to problems such as methodological weakness, incompleteness, outdated data, and poor verifiability, the information provided is far too complex to prepare procurement decisions regarding low-value products. Furthermore, the results for the textiles assessed in the existing life cycle assessments are not necessarily transferrable to the textiles considered by the procurer because of restrictive assumptions. Therefore, it is necessary to downscale the available information and synthesize it in an applicable decision support tool. Our decision vector consists of the key environmental aspects water, CO₂, energy, and waste and is completed by environmental management systems, eco-labels, and the countries of origin that matters for environmental and social aspects as well. Conclusions The decision vector supports procurers when considering environmental aspects in procurement decisions and provides a mechanism for balancing the information between overcomplexity and oversimplification. Therefore, it should be the basis for future development of an eco-label for operating room textiles.