Conditional recommendation, low to very low quality of evidence

Operating room: Operating theatres should be self-contained and have as few but sufficiently dimensioned doors as possible. If floor drains are required, techniques should be used to prevent contamination of the surrounding area.

Grouping of rooms and areas: Rooms or areas for the following functions can be combined for several operating theatres: Anaesthesia induction, patient preparation, anaesthesia discharge, patient aftercare, hand washing, hand disinfection. Other rooms can also be combined if this is possible in terms of infection prevention and function.

Instrument preparation: If instrument tables are not prepared in the operating theatre, but in a separate room, the same hygienic conditions (e.g. ventilation conditions) should be ensured there as in the operating theatre.

Staff changing room (staff airlock): In the staff changing room, the clean and unclean sides should at least be functionally separated. Crossing should be avoided in the routing. The unclean side must have sufficient space/cupboards for storing ward clothing and collecting bins for used area clothing, as well as washbasins, WC facilities and showers if necessary. On the clean side, storage facilities must be provided for the protected storage of the daily requirement of clean area clothing as well as facilities for hand disinfection.

Patient transfer room/area: In the patient transfer area, patients should preferably be transferred using transfer aids. Sufficient waiting areas for beds must be provided in the immediate vicinity. Additional patient changing rooms must be provided for outpatients undergoing surgery. The recovery room should preferably be located at the transition from the operating theatre department to the rest of the hospital and functional and organisational measures should be taken to prevent the principle of the staff airlock from being broken.

Material supply/disposal: A room or zone must be provided for the supply of materials where the goods are delivered without transport packaging. Accordingly, a separate disposal room must be provided for disposal. Within the operating department, clean goods (sterile goods, medicines, reprocessed equipment, etc.) must be stored in special rooms or in suitable containers in designated areas. Unclean goods (dirty laundry, waste, etc.) must be stored in the appropriate separate transfer room. Sufficient space must be provided for loaned instruments. An appropriate number of dispensers for hand disinfection and examination gloves must be provided throughout the operating theatre.

Surfaces: The surfaces of the rooms and operational installations (e.g. doors, shelving systems, lamps) as well as the equipment must be procured or positioned in such a way that soiling is minimised and they can be easily cleaned and disinfected. Surfaces must be intact without flaking (e.g. of paint) or surfaces that are difficult to clean/disinfect. The same applies to the storage of materials and equipment.

Ventilation: If the operating theatre department is equipped with a ventilation system, this must be regularly maintained to ensure that it meets the technical standard. Triple-filtered air is fed into the operating theatres (and preparation rooms for setting up instrument tables, if applicable). The operating theatres are pressurised in comparison to the adjacent rooms. Equipment with independent ventilation systems (e.g. hypothermia equipment for cardiosurgical operations) must be positioned or designed in such a way that they do not pose a risk of contamination of their own.

The use of LAF/TAV does not have its own infection prevention effect.

The separation of "clean" and "unclean" operating theatre departments has no infection-preventing effect of its own.