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Operating rooms are spacious, easy to clean in a cleanroom, and well-lit, typically with overhead surgical lights, and may have viewing screens and monitors. Operating rooms are generally windowless and feature controlled temperature and humidity. Special air handlers filter the air and maintain a slightly elevated pressure. Electricity support has backup systems in case of a black-out. Rooms are supplied wnith wall suction, oxygen, and possibly other anesthetic gases. Key equipment consists of the operating table and the anesthesia cart. In addition, there are tables to set up instruments. There is storage space for common surgical supplies. There are containers for disposables. Outside the operating room is a dedicated scrubbing area that is used by surgeons, anesthetists, ODPs (operating department practitioners), and nurses prior to surgery. An operating room will have a map to enable the terminal cleaner to realign the operating table and equipment to the desired layout during cleaning.

Several operating rooms are part of the operating suite that forms a distinct section within a health-care facility. Besides the operating rooms and their wash rooms, it contains rooms for personnel to change, wash, and rest, preparation and recovery rooms(s), storage and cleaning facilities, offices, dedicated corridors, and possibly other supportive units. In larger facilities, the operating suite is climate- and air-controlled, and separated from other departments so that only authorized personnel have access.

Temperature and surgical site infections (SSI). The current operating room design temperature is between 65 and 75° [1, 2]. Operating rooms are typically kept below 23°C (73.4°F) & room temperature is the most critical factor in influencing heat loss [4]. Surgeons wear multiple layers (surgical gowns, lead aprons) and may perspire into an incision if not kept cool and may decrease concentration and increase errors [4]. Higher temperatures increased subjective physical demand and frustration of the surgical staff [1]. One option is to heat the patient to prevent surgical site infections (SSI) and keep the surgical team cool. There is a 3 fold increase in infection for every 1.9 degree Celsius body temperature decrease [5] and radiation is the major cause of heat loss in patients, and convection (through air) is the second cause of heat loss [8]. In the first hour it is common for healthy patient’s temp decrease 0.5-1.5°C as anesthesia causes rapid decrease in core temperature [8]. One study found that the most efficient method of maintaining normothermia included using warm wraps and a heating blanket [6]. Additionally, pre-warming for thirty minutes may prevent hypothermia [4].

1.     Hakim, M., et al. (2018). The Effect of Operating Room Temperature on the Performance of Clinical and Cognitive Tasks. Pediatric Quality and Safety, 3(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132757/

2.     ANSI/ASHRAE/ASHE Addendum h to Standard 170-2008. (2011). Ventilation of Health Care Facilities. Retrieved from https://www.fgiguidelines.org/wp-content/uploads/2015/07/ASHRAE170ad_h.pdf

3.     Diller, K.R. (2015). Heat Transfer in Health and Healing. J Heat Transfer, 137(10): 11-112. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462861/

4.     Hart, S.R., et al. (2011). Unintended Perioperative Hypothermia. The Ochsner Journal, 11(3): 259-270. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179201/

5. Reynolds, L. et al. (2008 ). Perioperative Complications of Hypothermia. Best Pract Res Clin Anaesthesiol, 22(4): 645-657. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19137808?fbclid=IwAR2KUQW_S94A47LHVWi4p_j3YtaM6C-BBTm3j8KoUf9g6F6XsYs9L2Civ4k

6. Shao, Li et al. (2012). Methods of Patient Warming during Abdominal Surgery. PLoS One. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394771/

7. VanDerelzen, K. (2020, February 21). Personal interview.

8. Rosenberger, L et al. (2011). The Surgical Care Improvement Project and Prevention of Post-Operative Infection, Including Surgical Site Infection. Surgical Infections. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702424/

9. Ackermann, W et al. (2018). Forced-Air Warming and Resistive Heating Devices. Updated Perspectives on Safety and Surgical Site Infections. Frontiers in Surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258796/

It is recommended that operating rooms maintain low temperatures to help prevent surgical site infections (SSI). There are multiple regulatory bodies within the United States responsible for the regulations and management of predominant health care systems. One such body is The Joint Commission (TJC) which regulates the temperature and humidity of the operating room. Currently, standards are set are from 20 degrees Celsius