The document discusses the physical environment of the operating theatre (OT). It describes the ideal location and design of the OT, including classifications based on size, sterility, and specialty. It outlines the different zones in the OT from unrestricted to restricted areas. It provides details on the number and size of OTs, recommended surfaces, ventilation, lighting, and other facilities. The OT is designed to provide a controlled sterile environment to safely conduct surgical procedures.

1. TOPIC: PHYSICAL ENVIRONMENT OF
THE OT
Prepared by
Mr. Melvin Jacob MSc (N)
Assistant Professor

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• Sushruta , now referred to as the “Father of Surgery”
in the Indian tradition, worked and taught in India
around 600 BC.
• His many volumes of surgical descriptions, known
as the Sushruta Samhita, were the basis of Indian
surgical practice for many centuries after.
• He was the first to establish a surgical practical
laboratory, or workshop, using clay objects and
various fruits to mimic human surgical situations

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6. Evolution Of OT
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7. Modern OT
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8. Introduction
•Complex environment of
varying degree of sterility
•Iintegrating surgical and
anesthetic equipment
•Safe conduct of Surgery
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9. Introduction
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•Ideally, the operating theatre suite should be a
purposely built independent complex
•located away from the main flow of traffic but in an
area easily accessible to the…
• Critical care, surgical and maternity wards and
the supporting service departments, e.g. CSSD,
laboratory and X-ray departments.

10. Definition of OT
"Operation Theatre" is a specialized facility
of the hospital where lifesaving or life improving
procedures are carried out on human body by
invasive methods under strict aseptic conditions
in a controlled environment by specially trained
personnel to promote healing and cure with
maximum safety, comfort and economy.
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11. Principles
• Ensure patient safety and the highest quality of care
• Provide surgeons with appropriate access to the OR
• Maximize the efficiency of operating
room utilization, staff, and materials to reduce costs
• Decrease patient delays
• Enhance satisfaction among patients, staff, and
physicians
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12. Classifications of OT
Based on size
• Major OT
• Minor OT
Based on Sterility
• Ultra sterile OT
• Sterile OT
• Septic OT
Based on Specialty
• General OT
• Cardiac OT
• Neurology OT
• Orthopedic OT
• Ophthalmic OT
• ENT OT
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15. Cont…..
Based on construction
• Modular
• Non modular
Based on timing of surgery
• Routine
• Emergency
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16. Ideal location
Location:
• All OTs in an OT complex
• Emergency
• Blood bank
• Radiology
• Intensive care unit
• Central sterile supply department
• Laboratory
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17. OT design
Central corridor plan
• Racetrack plan - In this design, the front
entrance to each OR is from the outer corridor,
and supplies are retrieved through a rear
entrance to the room leading to the central-core
storage and work areas.
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19. Central corridor plan
• Hotel plan - In this design, the ORs are situated
along a central corridor, with separate clean core
and soiled work areas
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20. • Peripheral corridor - In this design, the front
entrance to each OR is from the peripheral
corridor, and supplies are retrieved through a
rear entrance from the OR leading to the central-
core storage and work areas.
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21. • Specialty grouping plan - The "specialty
grouping" plan is simply a variation on the hotel
or race track plan, in which ORs are grouped by
specialty (e.g., neurosurgery, general surgery),
each with its own closely associated clean
storage areas and, in some cases, each with its
own soiled instrument work area.
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22. Different Zones/ Areas
• Unrestricted zone or clean area.
• Semi restricted zone or sub sterile area
• Restricted zone or sterile area
• Disposal zone or area
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23. Unrestricted/ Clean zone or clean area
This is the area where hospital personnel,
OT personnel, patient's & their attendants can
move about in street clothes.
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24. Semi restricted/ Protective zone or sub-
sterile area
After changing from street clothes, with clean
gown, cap & OT slipper, the OT team or
personnel are, enter in this area
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25. Restricted/Aseptic zone or sterile area
• This zone has operation theatres & operation
room where operations are done.
• This is a place where staff & patients in street
clothes & shoes are not allowed to enter.
Scrubbed personnel wear sterile gowns &
gloves & get ready for operation procedure.
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26. Disposal zone or area
• Dirty utility area
• Disposal corridor
• OT attire mandatory in this area
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29. Sub areas
• Nurses station or counter
• Pre-operative check area- receive patients
• Holding area- IV line insertion, catheter / gastric
tube insertion
• Induction/Anaesthetic room
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30. Sub areas
• Post anaesthetic care units
• Staff room- Change dress from street cloth
• Sanitary facility for staff
• Rest rooms- Room for all grades of staff
• Laboratory- Small laboratory with refrigerator
• Seminar room
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31. Sub areas
• Waiting room – Patient's attendants or family
member's
• Utility Room - Instruments, articles, are
cleaned, washed & wiped dry & then wrapped,
stored & sent for sterilization.
• Disposal or sluice room – Receive disposable
items, separated according to biochemical waste
management
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32. Number & size
• As per the requirement
• The standard OT should be rectangular or
square in shape
• 20×20×10 feet in size so it provides a floor
space of 400 sq. Feet approx
• Spacious enough to allow free movement
Cont…
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33. Cont….
• Cardiac or neurosurgery OT should be bigger in
size of 20x30x10 feet with 600 sq. feet floor
space.
• OT for endoscopy or minor surgery can be of
small size of 18x18x10 feet with a floor space of
324 sq. feet.
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35. Doors
• Main door to the OT suite has to be of adequate
width (1.2 to 1.5 m).
• Sliding doors are preferred inside
• Made of steel.
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36. Surface / flooring
• Must be slip resistant,
• Strong with minimum joints
• Easily washable
• Able to absorb sound
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37. Walls
• Should be made of hard fire resistant,
• It should be light in colour
• Washable paint should be ideal
• Electric points should be available on the wall at <
1.5 m height from the floor.
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38. Scrub station
• For sterile hand wash
• Types: Stainless/ Granite/Marble/ Cement
• Hot water mixing: automatic or manual
• Non splashing taps
• Elbow/ Foot or Infra-Red operated taps
• Soap dispenser: Manual/automatic
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41. Ventilation, temperature & humidity
• Efficient ventilation that will control temperature
and humidity in OT
• OT should follow the principles that the direction
of airflow should take place from the sterile to
the clean zone & form the clean zone to the less
clean areas.
• No open window
Cont….
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42. • Should be no interchange air movement
between one OT and another
• No circulating fan or cross ventilation to prevent
airborne contamination of the surgical wound
• Air conditioning systems : recirculating and non
recirculating
• Humidity of 50-60% to be maintained
• Temperature between 18o-24oc.
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43. Lighting
• Overhead ceiling mounted unit
• Overhead light should be near daylight in colour
and shadow less and give25000-125000 lux of
light (50000 to 100000 lux at the centre and at
least 15000 lux at the periphery).
• Be spark-proof where anaesthetic gases are
used
• Produce minimum heat
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45. Emergency signal
• The OT management committee should
consider installing an alarm system in case of a
life-threatening emergency.
• The activation of this alarm will save valuable
time to mobilize the emergency designate staff
and direct them to the site of the emergency.
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47. Other facilities
• Electric generator - to ensure uninterrupted
electricity
• O2 supply & suction system- central O2 supply
system, suctioning through piped in suction
arrangement.
• Computer terminal - The modern OT construction
also provide a surface area for the computer
terminal in each OT
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Mr. Melvin Jacob MSc (N)
Thank you