Developed by a multidisciplinary Working Party, the guidelines provide practical recommendations covering theatre construction and upgrades, ventilation design, validation and annual verification processes, microbiological air sampling, and the management of ventilation-related risks. The guidance reflects significant developments in surgical practice since previous recommendations were published, including the rise of robotic surgery, hybrid operating theatres and modular surgical facilities. It also addresses the evolving evidence around conventional and ultraclean ventilation systems, while emphasising the importance of proportionate risk assessment and multidisciplinary decision-making.

Among the recommendations are maintaining positive pressure in operating theatres, ensuring appropriate air change rates, involving IPC teams in theatre validation and verification, and avoiding routine microbiological air sampling as part of annual theatre verification. The document also highlights the need for future-proofing facilities as new surgical technologies and techniques are introduced.

These evidence-based recommendations aim to improve patient and staff safety while helping IPC professionals, estates teams and clinical leaders navigate the increasingly complex environment of modern operating theatres.

Hilary Humphreys, Chair of the Working Party, said:

“We hope that this guideline with the supplementary material, will meet the needs of infection prevention and control practitioners in areas that many struggle with, as it relates to operating theatre design and ventilation, amongst other topics.  The aim of the multi-disciplinary group was to explain, simplify and perhaps even demystify areas that are comprehensively outlined in official UK documents but at a technical level.  Hopefully, the emphasis on multi-disciplinary decision making with good governance, together with clear practical advice, including how to take an air sample for microbiological sampling if indicated, will be welcomed."

Manjula Meda, Chair of HIS, said:

“The Healthcare Infection Society is committed to producing high-quality, practical guidance through its Guidelines Committee as a key strategic priority. We hope this guideline on operating theatres will help healthcare organisations across multiple disciplines make informed decisions, reduce the risk of healthcare-associated infections, and ultimately improve patient safety.”

The full guidance is published in the Journal of Hospital Infection and is freely available to download.