I. Project Overview

The clean operating rooms of the Emergency Surgery Building of Xinjiang Uygur Autonomous Region are located on the fourteenth floor, which has a floor height of 4.8 m and contains 20 rooms in total. Among them, there are 2 Class I operating rooms (1 radiation-shielded operating room), 8 Class II operating rooms (2 radiation-shielded operating rooms), 9 Class III operating rooms (1 radiation-shielded operating room and 2 positive/negative pressure switchable operating rooms), and 1 Class IV contaminated operating room. The clean corridors and the auxiliary functional rooms within the clean corridors are all Class 100000 (except for the contaminated surgery area). The thirteenth floor houses the anesthesiology department and auxiliary rooms for the operating rooms, with a floor height of 3.9 m. The equipment floor is located above the operating floor, with a floor height of 2.2 m.

II. Floor Plan Layout

The clean operating room project of the Emergency Surgery Building of the People's Hospital of Xinjiang Uygur Autonomous Region consists of 20 clean operating rooms and corresponding functional auxiliary rooms. The internal floor plan layout and corridor arrangement of the clean operating department conform to the principles of short and direct functional flow and clear separation of clean and dirty flows. This design adopts a double-corridor layout. The inner corridor is the clean corridor used by medical staff, patients, and clean items. The outer corridor is the dirty utility corridor, and all recovered contaminated items are centrally sent to the hospital's central supply room for unified disinfection.

Patients enter the clean operating department after the inside–outside stretcher exchange. Medical staff change their shoes and clothes on the thirteenth floor and then enter the clean operating department on the fourteenth floor via the staff-dedicated staircase. The two Class I operating rooms and the eight Class II operating rooms are grouped together at one end and separated by partition walls to ensure the high cleanliness of this area. Scrub sinks are distributed throughout the various areas of the operating department for the convenience of medical staff. Sterile items are transported by the central sterile supply center via the clean elevator to the sterile dressing room for use by the clean operating department.

III. Air-Conditioning and Purification System

The air-conditioning system project for the clean operating rooms of the Emergency Surgery Building of the People's Hospital of Xinjiang Uygur Autonomous Region employs a total of 20 super-hygiene type medical purification air handling units. Among them, the Class I and Class II operating rooms adopt the arrangement of one unit per operating room; the Class III operating rooms adopt the arrangement of two or three operating rooms sharing one unit; one of the positive/negative pressure switchable operating rooms and the separate Class IV operating room also adopt the arrangement of one unit per operating room; the clean corridor and the clean auxiliary rooms of the clean operating department share one unit, and the cleaning corridor and its auxiliary rooms share one unit.

The air-conditioning system adopts the primary return air mode. The system uses two fresh air pre-treatment units to perform centralized dehumidification, cooling, heating, and pre-filtration of the fresh air for this system. The fresh air is distributed at a constant rate to each independent system through imported constant air volume (CAV) devices installed on the fresh air ducts connecting to each circulation unit. The CAV devices are equipped with electric actuators and can be adjusted during normal use of the operating rooms and during on-duty periods, supplying respectively the fresh air for normal use and the fresh air for maintaining indoor positive pressure during on-duty periods.

The functional sections of the operating room purification air handling units are configured as follows: mixing section, fan section, air equalizing section, primary- and medium-efficiency filtration sections, cooling coil section, heating section, humidifying section, and air outlet section. In view of the cold weather characteristics of the Xinjiang region, the units are equipped with electric pre-heaters for fresh air, anti-freeze protection, and heat-preservation devices for shutdown periods.

In addition, to accommodate the fact that the operating room air-conditioning operating conditions and usage characteristics differ from those of general civil air conditioning, and in view of the climatic characteristics of the Xinjiang region, this project specially configured air-cooled heat pump units dedicated to supplying cooling and heating sources during transitional seasons for the air-conditioning system of the clean operating department, so that the cooling and heating supply of the system can be flexibly switched between the heat pump units and the system's central cooling and heating sources, thereby enhancing the reliability of the system.

A dedicated machine room is provided on the floor above the operating floor for the installation of the operating room air handling units and other equipment. Setting up a dedicated machine room above the operating rooms makes the system ductwork shorter, with low resistance and energy-saving operation, and the maintenance of the entire system is also relatively For convenience.

The system's cooling and heating source supply adopts a mechanical circulation two-pipe system, and humidification adopts the dry steam humidification method.

IV. Indoor Air Distribution

The clean operating rooms adopt an air distribution pattern of top supply and bottom return, in which Class I operating rooms adopt vertical laminar flow, while Class II and Class III operating rooms adopt turbulent flow according to their air change volume. The system installs a supply air plenum above the operating table in each operating room, with H14-grade HEPA filters arranged on both sides of the plenum as terminal supply air filters. After being filtered by the HEPA filters, the air is delivered into the plenum, then evenly discharged downward through the damping mesh beneath the plenum, and returns through return air outlets installed at the lower part around the operating room to the air handling unit for reprocessing. At the designed air change rate, air is continuously filtered and treated by the system, ensuring that the cleanliness in the operating room exceeds the design requirements.

To exhaust the disinfectant gases, anesthetic gases and unpleasant odors accumulated in the operating rooms, each operating room is independently equipped with a clean exhaust system, with the exhaust outlets located at the top on the patient's head side in the operating room.

V. Operating Department Drawings

The floor plan of the clean operating room is shown in Figure 1, and the floor plan, zoning diagram, and flow diagram of the clean operating department are shown in Figures 2, 3, and 4.

Figure 1　Floor Plan of the Clean Operating Room in the Emergency Surgery Building of the People's Hospital of Xinjiang Uygur Autonomous Region Figure 2　Floor plan of the clean operating department of the Emergency Surgery Building of the People's Hospital of Xinjiang Uygur Autonomous Region

Figure 3　Partial zoning diagram of the clean operating department of the Emergency Surgery Building of the People's Hospital of Xinjiang Uygur Autonomous Region

Legend: Class I operating room　Class II operating room　Class III operating room　Class IV operating room　No fill　Non-clean area Figure 4　Flow Chart of the Clean Operating Department of the Emergency Surgery Operating Rooms, People's Hospital of Xinjiang Uygur Autonomous Region

Legend:

  • Patient flow
  • Clean supplies flow
  • Medical staff flow
  • Waste flow