Surgery and Radiology Section

OPERATION THEATRE STERILIZATION

Disciplines in operation theatre

• Only people absolutely needed for an assigned work should be present.
• People present in theatre should make minimal movements and curtail unnecessary movements in and out of theatres, which will greatly reduce bacterial count.
• Air borne contamination is usually affected by type of surgery, quality of air which in fact depends on rate of air exchange.
• All the persons including the least cadre of employers are partners in infection control and should be aware to comply with infection control regulations.
• Prompt disposal of theatre waste out of the theatre is of top priority.
• Any spillage of Body fluids including blood on the floors is highly hazardous and prompts the rapid multiplication of Nosocomial pathogens in particular Pseudomonas spp.

General instructions

• Keep the floor dry when in use.
• Use only vacuum cleaners (booming to be forbidden as it will dispense the infected material all around and on the equipments).
• Chemical disinfection of an operation room floor is probably unnecessary.
• The bacteria carrying particles already on the floor are unlikely to reach an open wound in sufficient numbers to cause an infection.
• Cleaning alone followed by drying will considerably reduce bacterial population.
• Wall and Ceilings- Wall and ceiling are rarely contaminated.
• The numbers of bacteria do not appear to increase even if walls are not cleaned.
• Frequent cleaning is not necessary and has little influence on bacterial counts.
• Routine disinfection is therefore unnecessary, but only cleaned when dirty

Environmental cleaning of operation theatres

At the Beginning of the Day

• Only remove the dust with cloth wetted with clean water. ( Mop theatre furniture lamps, sitting tables, trolley tops, operation tables, procedure tables, Boyle’s apparatus)
  Note: Need not use chemicals/disinfectants unless contaminated with blood or body fluids between the procedures
• Clean operation tables or contaminated surfaces with disinfectant solutions.
  • In case of spillages of blood/ body fluids decontaminate with bleaching solution/ chlorine solution (10% available chlorine)
  • Discard  all the waste in plastic bags (do not accumulate around surgical sites)
  • Do not discard soiled linen and gowns in the operation theatre floor.

At the end of the day

• Clean all the table tops, sinks, door handles with detergent followed by low level disinfectant.
• Clean the floors with detergents mixed with warm water.
• Finally mop with disinfectant like phenol in the concentration of 1 in 10 (low concentrations of phenol will not serve the purpose).
• Keep the operation theatre dry for the next day’s work

Fumigation

• Seal the room with adhesive tapes round the edges of the doors/windows and ventilators and apertures.
• For Each 1000 cu.ft of space place 500ml formaldehyde (40% solution) and 1000ml of water in an electric boiler. Switch on the boiler, leave the room and seal the door.
• Seal the room for 24 hrs
• Then open the door and neutralize any residual formaldehyde with ammonia by exposing 250ml of S.G 880 ammonia/ 1Lt of formaldehyde used.
• Fumigation is obsolete in many developed nations in view of toxic nature of Formalin. Too frequent use and inhalation is hazardous

Ultra violet radiation

• U-V lights are fixed in the theatre
• Daily U-V radiation should be applied for 12-16 hours
• U-V radiation should be switched off before 2 hours of operation