1. Flow layer operating room - clean and warm working environment
  The laminar flow operating room not only requires highly clean air (the air entering the operating room must first be purified by high-efficiency filters), but also requires the ability to control the flow direction of the airflow (i.e. using laminar flow ultra clean installation), so that the airflow flows from the high cleanliness surgical area to the low cleanliness area, and takes away and discharges dust particles (dust particles) and bacteria in the airflow; Laminar flow is a small, thin layer of airflow that travels in the same direction at an average flow rate; The direction of purification airflow is divided into two types: vertical laminar flow and degree laminar flow. The vertical laminar flow high-efficiency filter is installed directly above the surgical bed, with the airflow blowing vertically and the return air port located at the four corners of the wall to ensure the cleanliness of the operating table meets the standard. Generally, vertical laminar flow is more effective in laminar flow operating rooms, which is a "positive pressure" environment, The air pressure varies depending on the cleanliness requirements of different areas (such as operating rooms, sterile preparation rooms, hand brushing rooms, anesthesia rooms, and surrounding clean areas).
Different levels of laminar flow operating rooms have different air cleanliness standards, for example, the US federal standard for a 100 level laminar flow operating room is ≥ 0.5 per cubic foot of air μ The number of dust particles in m is ≤ 100 or ≤ 3.5 particles per liter of air. Level 1000 is ≥ 0.5 per cubic foot of air μ The number of dust particles in m is ≤ 1000 or ≤ 35 particles per liter of air. And so on.
Different levels of laminar flow systems have different air replacement rates in the controlled space environment. The higher the cleanliness level, the faster the replacement rate, and vice versa.
The walls of the laminar flow operating room should be painted with special coatings with antibacterial properties, with bright light, mild color, and no need to clean and rinse with water.
(1) When entering the operating room, it is necessary to change hands, clothes, shoes, and hats.
(2) Strictly control the number of people entering the room.
(3) Try to reduce the number and time of opening doors in laminar flow operating rooms as much as possible (and do not open or close the doors), maintain a "relatively closed state" to prevent the entry of external pollution.
(4) Before surgery, wipe indoor items, medical instruments, equipment, etc. with alcohol.
(5) Timely and thoroughly clean all indoor items, walls, and the air after surgery.
(6) Women should not use cosmetics such as powders, hair sprays and nail polish to reduce the source of pollution.
(7) Work clothes should be made of polyester and nylon fabrics that are not prone to static electricity or loose fibers.
(8) Regularly check the functional status of the laminar flow system, test the cleanliness indicators of the ambient air in the laminar flow operating room, and cultivate bacteria.
In summary, the use of laminar flow operating rooms, strengthening aseptic concepts, and standardized management are still the basic guarantees and requirements for the safety of medical procedures, and remain the fundamental and key focus of operating room work. As long as the two are closely separated, they will tend to be successful.

2. Functional characteristics
2.1 Low bacterial count and low anesthesia gas concentration in the operating room.
2.2 Can provide warm airflow (indoor temperature can be between 15-25 ℃, humidity can be adjusted between 50-65%).
2.3 Positive pressure airflow (+23-25Pa) in the operating room to avoid the entry of external pollution.
2.4 The air in the operating room is fresh and clean, and the working environment is warm.
The 2.5 laminar flow operating room does not require the use of physical or chemical methods to stop disinfection under normal conditions, which not only saves labor but also eliminates the impact of adverse gases.
2.6 The hospital infection rate (especially surgical and burn infection rates) has significantly decreased.
2.7 Noise: Due to the use of air supply ceilings in laminar flow operating rooms, the main sources of noise are excessive return air vents and unreasonable exhaust design. Fortunately, the volume in the operating room is 42dB, which is not uncomfortable; The larger sources of noise are actually equipment and medical devices, and reasonable planning and decoration can prevent them.
The cost of a 2.8 laminar flow operating room is expensive, with a "monthly consumption of gold" and superior conditions, making it difficult to demand.

3. Management of laminar flow operating room environment
  The laminar flow system is a device for inventing a clean operating room, no matter how advanced it may be, it is not a "universal" device; Due to the lack of disinfection and sterilization effect of the laminar flow system, the "sterile" environment of the laminar flow operating room is mainly maintained through air filtration, laminar flow, and indoor maintenance of a "positive pressure" state.
4. Design equipment
  （1） Design of the operating room
Sitting south and facing north, located at a higher level of the building, adhering to the principle of clean air and avoiding hospital infections, the air and walls can be washed. The three zones should be reasonably divided: non restricted zone, semi restricted zone, and restricted zone. There should be three channels: staff channels, patient access channels, and dirt exit channels. Materials should be fire-resistant, moisture resistant, and not easily colored, preferably with properties such as easy cleaning. Modern operating rooms should be designed with air purification installation, central oxygen supply, central absorption, and other installations.
（2） Equipment in the operating room
In addition to regular operating room equipment, there should be a closed circuit television, air conditioning, and advanced electric knife (imported). To ensure that the surgery is not affected by unexpected power outages, hospitals should have power generation equipment. It is best to use modern carts such as communication carts to avoid air pollution in the operating room.
（3） Surgical room planning
We should strive for simplicity, and cabinets should be made of moisture resistant and sturdy materials for easy cleaning. All items should be fixed and stored in an orderly manner, striving for uniformity and standardization among different areas.
2、 Operating room staffing and hospital operating beds
The ratio of operating room nurses to operating beds should be 2.5:1, and teaching hospitals should be 3:1. The setting of the operating bed is: it is advisable to set one operating bed for 50 beds in the surgical department, and 0.5:1 for the health staff. Set up 1-2 head nurses.

The rules and regulations of the operating room

 The operating room is a place where surgeons, anesthesiologists, and operating room personnel work together. With a large amount of personnel activity, in order to ensure orderly work, not only are there procedures for various operations, but also certain work systems in place to ensure the smooth completion of various surgeries.
（1） Operating Room General Work Regulations
1. All staff entering the operating room must wear the shoes, hats, clothes, and masks of the operating room. When leaving the operating room, they should change their outerwear and shoes.
2. Visitors, learners, or interns from outside the hospital must obtain approval from the medical education department or nursing department and have a fixed location.
3. For elective surgeries in various departments, a surgical notice should be sent before 10:30 am on the day before the surgery. For emergency rescue surgeries, verbal notice can be given first, followed by a supplementary surgical notice.
4. The surgery shall be stopped according to the surgical notice time, and must be in place on time and cannot be changed arbitrarily. Contact the nurse for special situations.
5. Pick up the patient 30 minutes before surgery, bring along the medical record, and carefully check the patient's name, gender, age, bed number, diagnosis, surgical site, drug sensitivity test, and preoperative medication. After the patient enters the room, the itinerant nurse should double check and pay attention to the cleaning range of the patient's surgical area. Jewelry, dentures, and watches should not drive the operating room.
6. Strict aseptic operation techniques. Sterile surgery and bacterial surgery should be stopped in separate rooms, and special disinfection and sterilization treatment should be stopped for special infections.
7. Keep the room serious and quiet, stop loud noise, and do not chat or read newspapers during the surgery.
8. Strictly implement the indoor hygiene and cleaning disposal, isolation, disinfection and testing system, and implement medical safety prevention measures.
9. The operating room should always have various emergency surgical kits and rescue equipment available, and surgical instruments should not be borrowed. If borrowed, approval from the medical and educational department is required
10. The instruments in the operating room should be disinfected on a clean and clean basis, and various medical equipment materials should be placed in a fixed position. Valuable instruments should be kept by a dedicated person, and checked, maintained, and taken care of every month. The signs of highly toxic anesthetic drugs are obvious, and a dedicated person is assigned to lock and store them. Ordinary drugs are counted and recorded daily, and checked once a month. A dedicated person is responsible for this.
11. Responsible for the custody and submission of specimens collected during surgery. Doctors are requested to promptly fill out pathological specimens, submission forms, and cancel the submission, urging timely submission for examination.