Proper Dental Operatory Area & Operating Room Decorum

Definition

Operating Room attire is part of aseptic environmental control in the operating room that ensures a protective barrier for both patients undergoing surgery and personnel during surgical procedures.

Purpose

To provide protection from exposure to infection for both the patient and the surgical team members.

WHO: Ten Essential Objectives for Safe Surgery

1. Ensure the correct surgical procedure is carried out on the correct patient. 2. Operating personnel must have adequate knowledge of anesthesia, its methods of administration, and effects to minimize pain. 3. Personnel should be prepared for life-threatening conditions such as loss of airway or respiratory function. 4. The team should be prepared for risk of high blood loss. 5. The team must know the patient’s history to prevent allergic or adverse drug reactions. 6. Take measures to minimize formation of surgical site infections. 7. Do not leave any instrument or foreign material at the surgical site. 8. Identify and secure all specimens for further investigation. 9. Maintain proper communication among team members for safe conduct of surgery. 10. Hospitals must carry out routine surveillance of surgical volume, safety protocols, capacities, and outcomes.

Zones

Designated areas in the operating room based on degree of asepsis and required attire (usually unrestricted, semi-restricted, restricted).

Clean Attire Components

• One-piece half-sleeve clean cotton gown (female staff) • Two-piece cotton pajamas and half-sleeve, collarless, buttonless shirt (male staff) • Clean cotton head cover or cap • Pair of clean OR sandals or shoes

Timing of Use of Clean Attire

Personnel must change into clean attire upon entering the OR in the changing room located at the entrance.

Characteristics of Clean Attire

• Simple, half-sleeve, collarless, ankle-length cotton gown (female) • Clean cotton pajamas with drawstrings tucked inside (male) • Head cover or cap put on before scrub suit or sterile gown to avoid contamination by hair/dandruff • OR shoes without back strap, made of soft leather, well-fitted and comfortable

Sterile Attire

Includes sterile face mask, sterile gown, and sterile pair of gloves.

Sterile Face Mask

• Worn to cover both nose and mouth to minimize airborne infection. • Must be worn before entering restricted area to filter droplets containing microorganisms from nasopharynx and mouth while breathing, talking, sneezing, or coughing.

Code for the Use of Face Mask

1. Avoid frequent handling or touching of mask. 2. Do not hang around neck or reuse after use; discard in specific container. 3. Change mask between operations when soiled or damp. 4. Minimize talking and laughing while wearing mask.

Sterile Gown

Full-sleeve, full-length, collarless, buttonless gown with round neck, front closed, back opened, strings tied by assistant after wearing.

Sterile Pair of Gloves

Worn after the scrub gown; cuffs of gown sleeves tucked inside glove cuffs to maintain sterility.

Additional Rules for OR Attire

• Must be freshly laundered, washed, dried, and ironed (preferably in hospital laundry). • Worn within OR only. • Not to be taken home to avoid contamination of household articles and family members.