Disinfection practices differ significantly between procedure rooms and operating rooms (ORs), reflecting differences in infection risk, environmental control systems, and procedural complexity. While both areas require strict hygiene protocols, the OR is held to much higher standards due to the increased risk of surgical site infections (SSIs) and the invasive nature of the procedures performed there.

Infection risk is on average higher for surgeries performed in ORs compared to procedure rooms, necessitating more intense disinfection. ORs are specifically designed for aseptic precision, incorporating laminar airflow systems, positive pressure ventilation, and comprehensive sterilization protocols that include terminal cleaning, ultraviolet C (UV-C) irradiation, and routine surface disinfection. In contrast, procedure rooms, which are often used for minor interventions or diagnostic procedures, lack many of these advanced environmental features. Although they are cleaned according to standardized infection prevention protocols, the level of microbial control does not match that of the operating room.

A 2023 study by Gardner et al. evaluated the effectiveness of operator-driven UV-C disinfection compared with chemical methods in ORs. The study found that UV-C treatment significantly reduced bacterial load, particularly on high-touch surfaces, suggesting that the incorporation of such technologies may improve intraoperative sterility beyond that achieved by chemical disinfection alone (1). In addition, Jennings et al. demonstrated that the application of UV-C light to surgical back tables resulted in a measurable reduction in environmental contamination during surgery, reinforcing the role of adjunctive technologies in high-risk environments (2).

While procedure rooms do not routinely utilize such measures, alcohol-based disinfection and chemical cleaning agents remain essential to both procedure rooms and ORs. Gaspar et al. emphasized the importance of proper alcohol-based surgical hand preparation across all procedural contexts, highlighting its efficacy in reducing transient flora. Nevertheless, the absence of architectural features like HEPA filtration and dedicated sterile pathways in procedure rooms makes them inherently more susceptible to transient contamination (3).

Air quality and microbial burden represent another axis of comparison. Through an analysis of bioaerosol concentrations before and after disinfection in hospital ORs, Dehghani et al. found that microbial counts dropped significantly following conventional sterilization. These reductions were not as pronounced in general-use clinical spaces, highlighting the effectiveness of OR-specific environmental engineering and sterilization practices (4). Such evidence is consistent with observed differences in nosocomial infection rates between the two settings.

Behavioral and compliance factors related to disinfection also differ between procedure rooms and operating rooms. Ebadi et al. conducted an observational study of hand hygiene compliance within a surgical unit and found significantly higher compliance in dedicated surgical areas. This discrepancy is likely the result of both cultural factors and the stricter procedural oversight in the OR, where lapses in hygiene have immediate and serious consequences. In contrast, the multipurpose nature of procedure rooms and the diversity of their user base may contribute to variable adherence to protocols (5).

In conclusion, although both procedure rooms and ORs share the goal of minimizing infection risk, the tools, technologies, and protocols used to achieve this minimization differ widely. The OR benefits from a multi-layered approach that combines engineering, behavior, and disinfection technology, while procedure rooms operate within more basic frameworks. Future efforts may benefit from adapting some of the OR’s innovations—such as UV-C or air quality monitoring—into higher-risk procedure room settings when feasible.

References

1. Fickenscher MC, Stewart M, Helber R, et al. Operating room disinfection: operator-driven ultraviolet ‘C’ vs. chemical treatment. Infect Prev Pract. 2023;5(3):100301. Published 2023 Jul 28. doi:10.1016/j.infpip.2023.100301
2. Jennings JM, Miner TM, Johnson RM, Pollet AK, Brady AC, Dennis DA. A back table ultraviolet light decreases environmental contamination during operative cases. Am J Infect Control. 2022;50(6):686-689. doi:10.1016/j.ajic.2021.09.020
3. Gaspar GG, Menegueti MG, Lopes AER, et al. Alcohol-based surgical hand preparation: translating scientific evidence into clinical practice. Antimicrob Resist Infect Control. 2018;7:80. Published 2018 Jul 9. doi:10.1186/s13756-018-0372-7
4. Dehghani M, Sorooshian A, Nazmara S, Baghani AN, Delikhoon M. Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms. Ecotoxicol Environ Saf. 2018;164:277-282. doi:10.1016/j.ecoenv.2018.08.034
5. Baier C, Tinne M, von Lengerke T, Gossé F, Ebadi E. Compliance with hand disinfection in the surgical area of an orthopedic university clinic: results of an observational study. Antimicrob Resist Infect Control. 2022;11(1):22. Published 2022 Jan 31. doi:10.1186/s13756-022-01058-2