The document outlines essential rules and layouts for operating theatres, including the types of operations and necessary equipment. It emphasizes the importance of maintaining asepsis through personal attire, movement protocols, and handling of sterile instruments. Strict adherence to these rules is necessary to ensure a safe and sterile environment during surgical procedures.

1. Rules in the
Operating Theatre
Mr. Harshad Khade
MSc. Medical Technology (OTA)
Symbiosis International University, Pune.

2. Operation
All such diagnostic or therapeutic interventions, in which we disrupt
the body integrity or reconstruct the continuity of the tissues are called
operations.
Two types exist:
• Bloodless operations (e.G. Reducing a joint dislocation or treating a
closed fracture)
• Bloody operations (e.G. Abdominal or thoracic operations).
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3. Layout of the Operating Room
• The operating theatre is a 50-70 m² room, which does not usually have any
windows.
• It is adequately lighted and its walls are covered with tiles up to the ceiling.
• It is artificially ventilated and is air-conditioned.
• The operating complex must be architecturally separated from the wards
and the intensive care unit.
• The walls and floor of the operating room should have no gaps. They
should be cleaned easily.
• The doors should work automatically.
• It is equipped with central and portable vacuum system, as well as pipes for
gases.
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4. Main layout:
• Operating lamp,
• Operating table,
• Sonnenburg’s table,
• Supplementary instrument stand,
• Kick bucket,
• Suction apparatus,
• Diathermy,
• Microwave oven,
• Anaesthesia machine and
• Other instruments required during anesthesia
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5. Rules in the Operating Theatre
• Only those people whose presence is absolutely necessary should stay in
the operating room.
• Activity causing superfluous air flow (talking, laughing, and walking around)
should be avoided.
• Entry into the operating theatre is allowed only in operating room attire
and shoes worn exclusively in the operating room. This complete change to
the garments used in the operating theatre should also apply for the
patient placed in the holding area (i.e. dressing room).
• Leaving the operating area in surgical attire is forbidden.
• The doors of the operating room must be closed.
• Movement into the operating room out of the holding area is allowed only
in a cap and mask covering the hair, mouth and nose.
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6. General rules of asepsis concerning the
personal attire
• Taking part in an operation is permitted only after surgical hand
washing and scrubbing.
• The scrubbing person must not wear jewels.
• Watches and rings should be removed.
• Fingers and nails should be clean.
• The nail should be short.
• Nail polish and artificial nail are forbidden.
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7. • Surgical team members in sterile attire should keep well within the
sterile area; the sterile area is limited by isolation.
• Scrubbed team members should always face each other, and never
show their backs to each other.
• They should face the sterile field at all times.
• Non-scrubbed personnel should not come close to the sterile field or
the scrubbed sterile person, they should not reach over sterile
surfaces, and they should handle only non-sterile instruments.
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8. Behaviorus and movements in the sterile
operating room
• The personnel is always keeping in mind the rules of asepsis while moving:
• they face each other and the sterile territory (e.g. operating table) while
turnnig.
• They move in a way that their backs are facing the non-sterile surfaces.
• Always ”the thorax is facing the thorax” and ”the back is facing the back”!
Hands must be kept within the sterile boundary of the gown.
• Sterile hands must not touch the cap, the mask or the nonsterile parts of
the gown.
• Even spectacles must not be touched.
• You must not stretch out your hand to attempt to catch falling instruments
and you are not allowed to pick them up.
• Do not take any instrument from the instrument stand; ask the scrub nurse
to give it to you.
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9. General rules of the aseptic operating
room
• Only sterile instruments can be used to perform a sterile operation.
Sterile personnel can handle only sterile equipment.
• The sterile instrument will stay so if only the sterile person touch it (or
if it comes in contact with only a sterile object). Instruments are
locating below the waist is not considered sterile.
• If a sterile instrument comes in contact with an instrument of
doubtful sterility, it will loss its sterility.
• The edges of boxes and pots can not be considered sterile.
• A surgical area can never be considered sterile.
• However, the applications of aseptic rules of operations are
mandatory!
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10. “
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