The Operating Room Global Journal
Fumigation, Gaseous Decontamination, and No-Touch Environmental Technologies in the Operating Theatre: A Narrative Review
By The Operating Room Global (TORG), Amir Alex Jahangir, Atia Ur Rehman and 2 others.
Abstract
Background
Environmental decontamination is essential for infection prevention in operating theatres (OTs), yet terminology, evidence and implementation practices vary considerably.
Objective
To review the efficacy, safety and implementation of traditional fumigation and contemporary no-touch decontamination technologies.
Methods
A structured narrative search of PubMed/MEDLINE, Scopus and Google Scholar prioritised systematic reviews and OT-specific studies. Formal risk-of-bias and GRADE assessments were not performed.
Results
Formaldehyde demonstrates broad-spectrum antimicrobial activity but presents substantial occupational health risks and prolonged environmental persistence. Vaporized hydrogen peroxide and aerosolized hydrogen peroxide are distinct technologies, with vaporized hydrogen peroxide having the strongest evidence base among gaseous approaches, although clinical findings remain variable. Ozone and chlorine dioxide demonstrate antimicrobial efficacy under laboratory conditions, but clinical evidence is limited and stringent safety measures are required. Ultraviolet-C has moderate supporting evidence as an adjunct to manual cleaning. Plasma air treatment and far-UVC require further evaluation, while photocatalytic coatings remain investigational. Clinical trials have not established a clear benefit for plasma air treatment.