Structure of the surgical area / areas

At the time of entering the surgical area, certain steps and procedures should be performed, since this area is delicate and requires specific care by the entire surgical team, this includes surgeons, anesthesiologists, instrumentalist nurses and nursing students and medicine.
That is why it is very important to know the areas that make up the entire surgical area in order to obtain the optimal hygiene conditions within the surgical hospital environment.

Mainly we should know that the surgical area is made up of different areas. These areas are created for various purposes, one of them is to prevent the spread of pathogens is the minimum within the operating room, remember that this is where we will perform delicate interventions in the patient that requires it, where they will surely require a incision. Therefore, it seeks to eliminate infections by the entry of external pathogens.

That is why the surgical area is divided into three areas.

1.- Black area
2.- Gray area
3.- White area

They can be called both "zone" and "area". It is independent of each health staff.

`Black area`

This area is the most common, here the medical and nursing staff can wander with the clinical gown without any problem. This area is of high importance since this is where the change will take place to enter the surgical area, specifically the change will occur in the changing rooms of health personnel when using the appropriate clothing to enter the operating room.

This area is made up of bathrooms, dressing rooms, staff offices (both medical staff and nursing staff), the admission room (here is where patients are received to be admitted and in some cases also for discharge, that is, in a nutshell, to enter the surgical area and be able to leave the surgical area) and we can also find what the waiting room is (where both patients and family members wait; whether for admission, discharge, or intervention).

The black area is usually enabled (this may vary from the hospital unit where you are and its regulations) for both health personnel and patients with their families.

`Gray area`

This area is characterized by being the middle part of both areas, this is where the change of costumes of the surgical team will occur. This area is made up of the aisles within the surgical area and the post-anesthetic care unit.

Why should staff make a change of attire?

This is mainly done as a protection and barrier method. In what way? The idea of changing the attire that we have before is to prevent the spread of pathogens within the operating room, that is, not to bring the microorganisms from outside to the inside of the operating room. Therefore, it is important to keep the surgical pajamas in optimal hygiene conditions, and place it exclusively when entering the operating room area.

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In Venezuela, or at least in my city, it is required that the surgical uniform should be green, usually it is an emerald green, but it depends on the staff the variant color of the same that they wish to choose.

✔ In addition, accessories such as tendrils (earrings), bracelets, necklaces (pendants), rings, piercings, among others, must be left.

Mainly women should collect our hair in a correct way when placing the surgical cap, a kind of bun is usually made in the back and we proceed to place the cap, so that no hair is left outside the cap , because this will allow bacteria, viruses, microorganisms themselves, can lodge in our hair.

The caps of men and women are different, because in general, women usually have more hair, therefore something larger is needed to be able to store it correctly.

Why is a hat used?

It is used in order not to carry pathogens from outside to the surgical area and not to carry pathogens from the surgical area to the outside, it is a method of protection, a barrier.

There are different models of hats, and both men and women usually customize them to your liking.

Another necessary tool to enter the surgical area is the cap. Although it is only used mainly in the white area, it should always be at hand in case of an emergency so that it can act quickly and efficiently.

Here in my country due to the shortage of inputs, usually most of the staff have their own cloth mouths, these are also usually customized.

And last but not least, in that case (from my point of view) I think it is one of the most important, is the implement of the boots covers. They are indispensable to enter the surgical area, and this happens since there are millions of external pathogens in our shoes, since all the dirt is mostly on the floor and we carry them with us through our shoes.

Here in the hospital a pair or two pairs of boots covers are usually placed for greater protection (since many times debris falls to the ground and these end up being stepped on by our feet; for example the most common is usually the blood).

I would lie if I say that these are also made of cloth, because to be honest I have never seen any person who uses them custom, and this happens because they are implements that really need to be discarded after use.

In some cases there are no boots covers, so female caps are used, and in case there is no such input, surgical gowns are usually had that are "clean" to place them in the shoes.

So knowing this, we consider that the main implements to enter the operating room are:

1.- Surgical pajamas
2.- Cap / hair cover
3.- Covers mouth
4.- Cover boots

`White area`

This is the most important area within the surgical area, as this is where the intervention will be performed. This area is composed within the operating room as such, and should be maintained with a disinfection of pathogens, thus trying to make it as sterile and clean as possible to prevent the spread of pathogens and in turn complications from infections.

Here the staff must enter with previous hand washing and perform the surgical technique for the intervention that requires it. In addition to this they should always wear the mouth cover, the caps must be well placed (without hair remaining outside it) and the boot covers must cover the entire dorsal part of the foot.