Exploring Current Research Direction and Potential Ventilation Approaches in Hospitals’ Operating Room:  A State-of-the-Art Analysis

This article reviews the current and potential trends in ventilation strategies within hospitals’ operating rooms (ORs), with a specific focus on vertical downward ventilation systems meeting cleanroom criteria. It also explores potential innovations, including thermal-guided mobile air supply units and the possibility of localised exhaust systems mounted on operating tables. By evaluating existing ventilation systems and emerging technologies, this review aims to provide valuable insights into optimising surgical environments to ensure improved patient safety and outcomes. Vertical downward ventilation systems, currently widely deployed in modern ORs, adhere to stringent cleanroom criteria, maintaining sterile conditions by efficiently controlling air flow and minimising airborne contaminants. These systems utilise High-Efficiency Particulate Air (HEPA) filters and controlled airflow patterns to create a clean and controlled environment conducive to surgical procedures. While vertical downward ventilation remains the prevailing practice, the potential integration of thermal-guided mobile air supply units represents an exciting innovation. These units offer dynamic airflow control based on real-time temperature gradients within the surgical zone, potentially enhancing contaminant control and settlement rate. Also, the possibility of localised exhaust systems mounted on operating tables presents another avenue for improving ventilation efficiency. By efficiently capturing and removing contaminants generated during surgical procedures, localised exhaust systems have the potential to further reduce the risk of surgical site infections and improve overall cleanliness in the vicinity of the surgical site. This review concludes that combining a mobile air supply unit with thermal control capabilities, in addition to integrating it with a vertical downward ventilation airflow system, appears to be the optimal choice for reducing low concentrations near the patient's vicinity. By synthesising current practices with potential innovations, this review could assist healthcare professionals and facility managers in the evolving landscape of ventilation strategies in ORs. The adoption of advanced ventilation technologies and practices contributes to advancing surgical care and enhancing patient safety in healthcare settings. Future studies could consider integrating the Internet of Things (IoT) for automatic indoor air quality optimisation through ventilation control.