Table 3.
The terminal disinfection measures for Level-Ⅲ surgery
| Disinfection items | Disinfection method 1 | Disinfection method 2 | |
|---|---|---|---|
| Air* | General operating room | Using the atomization way disinfection with hydrogen peroxide (3%), room closed >1 hour | Ultraviolet radiation disinfection >1 hour |
| Negative pressure operating room | Before disinfection, shut off the laminar flow and air supply system, use the atomization way disinfection with hydrogen peroxide (3%), room closed >1 hour, after that, laminar flow and air supply system continue to run a self-purification cycle. | — | |
| Surface of object | Instrument table, equipment, operation table and filter screen of return airport, etc. | Surface that can be disinfected with chlorine disinfectants‡: spray or wipe with chlorine-containing disinfectant (1,000 ppm) >30 minutes, and then wipe with clean water. For the surface with blood, body fluid and other pollutants of the patient, should be carefully removed with an absorbent material with chlorine-containing disinfectant (5,000 ppm), and then to be disinfected routinely. | Surface that cannot be disinfected with chlorine disinfectants: wipe with 75% alcohol for disinfection |
| Ground | Use chlorine-containing disinfectant (1,000ppm) to spray and disinfect once from the outside to the inside, and disinfect a passage. After indoor disinfection, spray again from the inside to the outside, disinfection effect for more than 30 minutes.22 | — | |
| Wall | Chlorine-containing disinfectant (1,000 ppm) is sprayed for disinfection. (If the wall is visibly soiled with blood/body fluids) | — | |
| Anesthesia machine† | The professional engineer disassembles the breathing circuit in the anesthesia machine and sends it to the disinfection supply center for sterilization. | Disinfect with compound alcohol anesthesia circuit disinfector23,24 | |
| Transport bed | After being disinfected by hydrogen peroxide (3%) spray in the operating room, chlorine-containing disinfectant (1,000 ppm) was used to wipe and disinfect. | — | |
The disinfectant is atomized into tiny particles under 20 microns, uniformly sprayed in the air so as to make full contact with the microbial particles and kill the microorganisms. Before disinfection, protective sleeve should be used to protect the precision instrument from corrosion. These measures of air disinfection are formulated in accordance with domestic guidelines, and whole room disinfection with vaporized disinfectants is not necessary according to WHO guidance, so those in other countries should follow existing national guidelines or the guidance from WHO.18, 19, 20, 21
It is suggested that after the terminal disinfection in the operating room, the professional engineer dismantle the anesthesia machine, and then disinfect the local environmental surface after the dismantling.