Comprehensive infection control in operation theatres: Current standards, practical strategies, and innovations to enhance surgical safety

Operating rooms (ORs), also known as surgical theatres, are the heart of surgical procedures, a unit within a hospital. They are designed to provide the patient with a sterile and infection-free environment. However, there is a risk of exposure to infectious agents, such as Staphylococcus aureus (including MRSA), Pseudomonas aeruginosa , and Streptococcus species. They affect the superficial skin, but in cases of severe infection, they lead the infection to deeper tissues, and the organs or contents (muscle layer, fascia, soft tissues, and blood vessels) that are exposed during the surgical procedure increase the risk of infection, eventually resulting in surgical site infection (SSI). There may be several postoperative complications, such as a delay in the healing of the wound or opening of the wound completely or partially due to SSI. To reduce contamination of pathogens, we practice preventive strategies with their advancements, like the practice of double gloving, which is used to reduce the risk of needle stick and other sharp injury traumas. The rate of single glove puncture during the surgical procedures was 90.2%, and with the combination of two gloves, it was 23%. In an OT, around 10,000 skin scales are shed per minute by the operating staff. However, about 10% of people have bacterial clumps that could lead to a postoperative complication. Control of contamination in airflow systems can be done using vertical laminar flow with high efficiency particulate air (HEPA) filters, which remove 0.3 mm particles with an efficiency of 99.9%. Installation of the ultra clean ventilation (UCV) system in the OT reduced the joint sepsis to 1 and 10 biological contaminant particles per cubic meter (BCP/m 3 ). Heating, ventilation, and air conditioning (HVAC), which controls the temperature, relative humidity, and air current. The study on the Efficacy of Nosocomial Infection Control (SENIC) showed that SSIs were reduced by 38% as a result of infection control teams, surveillance, and feedback of observed data. The surgical scrubs used in the OT were washed and reused, but the overall performance was affected due to contaminated stains and wear and tear. The number of washes affected the quality of the material, which increased the chances of exposure to pathogens. Polypropylene scrub suits are associated with lower bacterial contamination for single-use purposes, which reduces the risk of cross-contamination as compared to traditional scrubs. By using antibiotic combinations, a wide spectrum of pathogens can be treated. Nanotechnology carries the nanoparticles, which encapsulate the antibiotics, to release at localized surgical sites, which ultimately aims to enhance the efficiency and reduce the adverse effects of antibiotics. The implant is coated with an antimicrobial material that provides resistance towards the microorganisms within the blood during the surgical procedure. Further study shows that by analyzing the patient’s genetic makeup, the target genomic site is exposed to effective antibiotics. Knowledge and practice of health care workers (HCWs) also play a crucial role in the prevention of SSI. This paper aims to summarize the methods to minimize the SSI and focus on the prevention practice strategies with their advancement.