Studies show that surgical site infections (SSIs) constitute around 20% of total hospital-acquired infections. So infection prevention and control in operating theatres is essential for ensuring the safety of the patient.

Sources of Infection in Operating Theatres

Most SSIs occur during the operative procedure, when the patient’s wounds are still open. Sources of infection can include:

• Members of the operating team, and the clothing they wear.
• The operating theatre environment, including the air quality.
• The equipment used during the procedure.

Stringent protocols can make a huge difference in minimising the onset of SSIs. Every medical setting should have a robust set of infection control protocols in place, and every member of the operating staff should be familiar with these protocols.

Please note that this post should not be used in place of infection control protocols. Rather, it should be used as a general guide to the sort of items that might factor into your protocols.

Operating Room Environment Measures to Control Infection

The operating theatre should be aseptic, highly-sterile, and restricted. The following measures can help prevent and control infection in operating theatres:

• Proper ventilation with 20 air changes each hour.
• Separate doors for entry and exit. Sliding doors can minimise air currents as people enter and leave the room.
• The operating theatre complex should be properly zoned based on the levels of cleanliness, the presence of microorganisms, and the types of procedures carried out. There should be separate areas for preparation and disposal, for scrubbing and gowning, and for the storage, sterilisation, assembly and washing of materials and equipment.

Staff Clothing

All surgical staff must carry out a surgical hand wash before the procedure. This involves applying an antimicrobial agent in a circular motion, from the tips of the fingers up to about 5cm above the elbow. This rubbing should take place for at least three minutes.

When it comes to operating theatre clothing, use “barrier techniques” where the chances of infection spread are highest. Ideally, all operating theatre clothing should be disposable, and where possible, made from soft, nonporous materials.

• Head covers – All facial and head hair should be properly tied and covered. Long hair should be tied into a bun.
• Masks – Masks work to prevent the transmission of infectious agents from the operating team to the patient’s open wounds. They also protect the operating team from splashes and sprays from the patient. The masks should be disposable, made from synthetic materials, and properly fitted.
• Scrubs– Scrubs should be comfortable and, if not disposable, they should be easy to wash and clean. They should have as simple a design as possible, to reduce the areas where contaminants could develop.
• Gowns – When it comes to gowns, there should be a set procedure for applying them to reduce the risk of contamination. It’s a two-person job, in which both people should avoid touching the outside of the gown.
• Gloves – Again, there should be a set procedure for applying gloves. It begins with a thorough handwash in aseptic conditions, after which you should avoid, as much as is possible, touching the outside of the glove with your bear hands.

Operating theatres must also use drapes to contain the operating environment, and to cover all parts of the patient apart from the operative site.

Surgical Equipment Cleaning for Infection Prevention

All operating theatre machinery must be surveyed at least once a week. Any fault should be reported to the infection control team, who can then take appropriate measures to maintain the infection control protocols.

Any reusable surgical instruments must be thoroughly cleaned before use. The reprocessing procedure might involve:

• Cleaning – To remove any organic matter on the surface of the equipment. Some equipment may require soaking prior to cleaning.
• Disinfection and sterilisation – Disinfection involves using appropriate chemical disinfection agents to reduce the number of microorganisms present. Sterilisation involves removing all microbes from the surface of the equipment, including spores, using steam, dry heat, ethylene oxide, or other chemicals. It’s usually necessary to wrap or package equipment before sterilising it.
• Storage – Once processed, all surgical equipment must be properly stored in a sterile environment, and only handled again once it’s ready to be used on patients.

The specific cleaning procedure will vary depending on the type of equipment. For example, some surgical equipment can be cleaned and dried in an automated washer. Some instruments may require cleaning in an ultrasonic unit, after which they’ll need to go through a separate rinsing and drying procedure before they’re sterilised ready for storage.

Floor and Surface Cleaning in Operating Theatres

From floor to ceiling, all surfaces should be washable and with a minimum of joints. This will help reduce the accumulation of dust and other particulates.

Absorbent mats can also make a huge difference. They can capture fluids during procedures, making it much easier to dispose of them afterwards. This can vastly improve your turnaround times with no need to compromise on hygiene standards. They also dry quickly, which can help prevent slips and falls.

Essential Support for Infection Prevention and Control in Operating Theatres

We offer many services and solutions that can help you stay on top of infection prevention and control in operating theatres.

Our services include:

• Air purification
• Face-fit testing
• Washroom hygiene solutions
• Fluid management solutions, including floor mats
• Comprehensive infection control solutions, including cleaning equipment, disposal containers, and sanitising chemicals

Our experts are always on-hand to discuss your needs. So if you’d like some guidance on infection prevention and control in operating theatres, get in touch to talk to an expert today.