Cupboard Placement in Modular Operating Theaters
Yes, cupboards can be placed in modular operating theaters, but only if they meet strict infection control criteria: they must be closed storage systems that minimize equipment exposure, are positioned to avoid interfering with traffic flow and ventilation systems, and contain only essential items needed for procedures.
Core Infection Control Principles for Storage in Operating Theaters
The fundamental concern with any storage system in the operating theater is preventing environmental contamination and maintaining proper airflow dynamics. Equipment kept in each OR must be minimized to what is strictly necessary on a case-by-case basis 1. This principle directly applies to cupboard placement and contents.
Critical Requirements for Cupboard Installation
Cupboards must be closed storage systems rather than open shelving to prevent dust accumulation and bacterial dispersal into the operating environment 1, 2.
Positioning must not obstruct traffic patterns or interfere with the ventilation system's efficiency, as doors must remain closed and air circulation must be maintained 1, 2, 3.
Storage should be located outside the immediate sterile field to minimize the need for personnel movement during procedures, which increases airborne contamination 1, 3.
Contents must be limited to essential, frequently used items for that specific operating room, with standard anesthetic trolleys replaced by dedicated pre-prepared ones 1, 2.
Evidence-Based Storage Design Considerations
Minimizing Environmental Contamination
The most probable routes for transmission of infection between successive patients are airborne or through items and surfaces that have contacted patients 1. Any equipment not necessary for the intervention must be moved away from the patient transit route 1. This means cupboards should:
- Be positioned along walls away from the patient transfer pathway 1
- Contain only procedure-specific supplies rather than general storage 1, 2
- Have smooth, easily cleanable surfaces that can be disinfected between cases 1
Traffic Flow and Access Patterns
General traffic in and out of the operating theatre must be kept to a minimum, with doors kept closed to ensure ventilation system efficiency 1, 2, 3. Cupboard placement should:
- Allow staff to access supplies without excessive movement during procedures 3
- Be designed so that a team member can retrieve equipment without entering the sterile field 3
- Not require opening during critical phases of surgery when sterile conditions are most important 4
Modern Modular OT Storage Solutions
Recent evidence supports advanced storage systems in operating theaters. A 2022 study demonstrated that stacker cranes (automated storage systems) can maintain acceptable environmental conditions for sterile device storage, with lower non-conformity rates (9.7% for surfaces) compared to traditional sterile storage rooms (41.7%) 5. This suggests that well-designed enclosed storage systems can actually improve infection control compared to traditional open storage.
Modular OT Specific Requirements
For modular operating theaters specifically, Indonesian Ministry of Health regulations require 6:
- Walls and ceilings must be insulated with PUF, EPS, or stainless steel panels 6
- Bacteriostatic floors with corner covings to facilitate cleaning 6
- Use of sterile corridors for equipment and supply movement 6
- Comprehensive utility pendants rather than floor-based storage where possible 6
Critical Pitfalls to Avoid
Never place open shelving or uncovered storage in the operating room, as contamination rates increase significantly with exposure time (30% contamination at 4 hours for uncovered trays) 4.
Avoid cupboards that require frequent opening during procedures, as this disrupts airflow and increases personnel movement 1, 2, 3.
Do not use cupboards as general storage for non-essential equipment, as this violates the principle of minimizing equipment in the OR 1, 2.
Ensure cupboards do not obstruct door closure or ventilation system function, as keeping OR doors closed is essential for maintaining proper air pressure and reducing airborne contamination 1, 2, 3, 7.
Cleaning and Maintenance Protocols
All surfaces and electromedical devices must be accurately cleaned and disinfected after each procedure 1. For cupboards in modular OTs:
- External surfaces must be cleaned between all patients 1, 2
- When visible contamination with blood or body materials exists, disinfect with sodium hypochlorite according to local protocols 1, 2
- Interior surfaces should be cleaned at the end of each session 1, 2
- High-touch surfaces (handles, commonly accessed areas) require more frequent cleaning schedules 3