13.2.1 Operating Room Personnel Attire Management

The purpose of attire management: The human body is the main source of biological contamination in the operating room, and operating room attire should be designed to improve the cleanliness of the operating room. Operating room attire also includes caps, masks, protective goggles, and other items, which serve as protective barriers between staff and patients.

(1) All personnel entering the clean and ultraclean areas of the operating room must wear clothing that complies with the attire regulations:

1) Since surgical gowns are easily contaminated during wear, they must be collectively laundered after each use.

2) Once a surgical gown becomes soiled or wet, it must be replaced promptly to reduce the spread of microorganisms.

3) Surgical gowns must not be worn outside the operating room area; when leaving, a single-use long gown tied at the back (outside gown) must be worn over it, and upon returning to the operating room, the outside gown must be removed and placed in the soiled linen bag.

4) The design and material of surgical gowns should be fire-resistant, antistatic, wear-resistant, and impermeable to prevent microbial penetration; at the same time, attention should be paid to comfort, and they should not cause allergic reactions.

5) All personnel should wear two-piece tops and trousers or a one-piece dress; personal long underwear must not be worn underneath; when wearing a two-piece surgical gown, the top should be tucked into the trousers; non-scrubbed personnel must wear long-sleeved outer garments with all buttons fastened.

(2) A surgical cap must be worn in the clean and ultraclean areas; the surgical cap should cover all hair on the head and face; those with long hair should first coil up and secure their long hair before putting on the cap; reusable caps should be washed clean after each use.

(3) All personnel entering the ultraclean surgical area must wear a mask, which should be replaced promptly when it becomes wet or contaminated.

(4) Pay attention to the use of protective equipment, such as gloves, goggles, face shields, shoe covers, and waterproof aprons.

(5) Operating room staff must pay attention to personal hygiene and appearance: bathe daily, trim nails frequently, do not wear nail polish or artificial nails, pay attention to handwashing, avoid heavy makeup, do not wear jewelry, and wipe eyeglasses with cleaning disinfectant solution before surgery.

13.2.2 Management of Personnel Entering and Leaving the Operating Room

(1) All personnel entering the operating room should register in accordance with operating room regulations, change into appropriate attire, and dress neatly. (2) The operating room should establish a strict visitor system; those admitted under special circumstances should be accompanied by at least one nurse to restrict and supervise their range of activities.

(3) Patients with upper respiratory tract infections or highly contagious diseases should undergo surgery in a negative-pressure operating room.

13.2.3 Management of the Patient's Skin

The purpose of skin preparation: to remove dirt and transient flora, reduce resident flora to a minimum, and inhibit the rapid growth of microorganisms.

(1) After entering the operating room, the patient's surgical site and the surrounding skin should be clean. This can be accomplished by having the patient bathe before surgery, having another person assist in cleaning the surgical site, or cleansing the surgical site with an antiseptic agent after entering the operating room.

(2) Before skin preparation, the condition of the skin at the surgical site should be assessed, such as for the presence of hemorrhoids, warts, skin breaks, and so on. If hair removal is needed, it should be performed in the ward as close to the time of surgery as possible.

(3) The skin of the surgical site and surrounding areas should be disinfected with an antiseptic agent. Attention should be paid to the order and extent of disinfection, as well as the temperature and amount of the antiseptic agent; it should be allowed to evaporate to dryness before the surgical drapes are applied.