Hand Surgical Operating Room Size Allocation: A Comparative Space Utilisation Study

<b>Background:</b> This study evaluated operating room (OR) space required for various hand surgical procedures. We analysed the size requirements for hand surgical cases divided into four settings: (1) large OR setting requiring fluoroscopy and microsurgical equipment, (2) medium-sized OR setting for cases requiring fluoroscopy, (3) smaller OR setting and (4) minor procedural room without anaesthesia with the aim to describe room size requirements for hand surgery practices. <b>Methods:</b> A variety of hand surgical cases were selected: large cases (microvascular digit replantation), medium-sized cases (closed reduction percutaneous pinning [CRPP] of phalangeal fractures) and smaller cases (carpal tunnel release [CTR]) with and without anaesthesia. Space requirements were compared to general surgery cases (laparoscopic appendectomy) and general orthopaedic surgery cases (cephalomedullary nail [CMN]). Necessary operative equipment was measured (ft²) to calculate requirements for each procedure. <b>Results:</b> Large hand cases such as digit replantation necessitated the most OR space (125 ft²), followed by general orthopaedic cases (CMN; 118 ft²), medium-sized hand cases (CRPP phalanx; 107 ft²), general surgery laparoscopic appendectomy (68 ft²), small hand cases (CTR; 85 ft²) and minor procedures (49 ft²). <b>Conclusions:</b> Hand procedures can be divided into major procedures requiring significant OR space (125 ft²), medium procedures in standard OR suites (107 ft²), procedures in small ORs with anaesthesia (81 ft²) or office-based setting without anaesthesia (49 ft²). These findings help define space utilisation for hand procedures and may have practical implications related to efficiency, cost and patient safety in the hospital and outpatient setting. <b>Level of Evidence:</b> Level IV (Economic and Decision Analyses).