OP E R ATING THEATR E S
Optimising lighting for surgical specialties
Lindsay Keeley, patient safety and quality lead, for the Association for Perioperative Practice, provides an insight into the importance of surgical lighting and the demands surgical specialties have on theatre lighting.
The operating theatre is a challenging controlled environment that has become more complex and technically challenging since the discovery of electricity in 1879, and the subsequent advances in surgery across all specialties we now see today in the 20th century. This has influenced the demands placed on theatres and surgical lighting as technology and equipment has advanced across numerous specialties. There are several Health Building Notes (HBNs) which provide a framework and
guidance on facilities required for operating theatres and specialties with specific functions and design requirements: l HBN 26 (2004), Facilities for surgical procedures: Volume 1.
l HBN 10-02 (2007), Day surgery facilities. l HBN 01-01 (2013), Cardiac facilities.
The above building notes will identify and provide the exact guidance and requirements recommended to deliver “Best Practice” in planning both new and modifying existing
surgical facilities. It is essential to provide some natural environmental lighting in operating theatres; however, this may not always be possible and, in this instance, artificial lighting should be considered as an alternative. A surgical field lighting analysis should be considered of the environmental and associated surgical challenges. The lighting can consist of different models: some with integrated cameras; they can be single or two arm pendants with multiple luminaire systems attached to a suspension arm, which is normally mounted at a fixed point on the ceiling; or positioned along a ceiling mounted track.
The surgical lights can be categorised by lamp type or configuration (WHO 2012): l Conventional (incandescent) quartz, xenon, or tungsten (filled with halogen).
l LED (light emitting diode). l Ceiling-mounted. l Floor standalone (mobile). l Wall mounted (used normally for examination purposes).
The surgical environment is relatively static in nature, in terms of the walls, floors, and ceilings, whereas surgical procedures advance and best practice evolves, as new clinical techniques are implemented and established. This requires a change to an initially otherwise well-designed surgical environment that soon becomes outdated (Barach & Rostenberg 2015). Operating theatre lighting should be
In a study identified by Curlin & Herman (2020), on average a light adjustment occurred every 7.5 minutes causing the surgeon in 97% of cases to pause and stop what they were doing.
OCTOBER 2020
comfortable, safe and deliver optimal visibility, contrast and colour recognition across all specialties providing a satisfactory visual environment (Association of periOperative Registered Nurses [AORN] 2019). Effective lighting that does not cause glare or shadowing can enhance surgical performance.
Some surgical lights are known to emit radiant heat, causing discomfort for the surgical team and damage to exposed tissue. It is important to be aware of the incidence
WWW.CLINICALSERVICESJOURNAL.COM l 19
▲
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92
