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The Guideline for Design and Maintenance of the Surgical Suite was approved by the AORN Guidelines Advisory Board and became effective as of July 20, 2023. Information about the systematic review supporting this guideline, including the PROSPERO registration number, systematic review questions, description of the search strategy and evidence review, PRISMA 2020 flow diagram, evidence rating model, and evidence summary table is available at


The physical design of the surgical suite should support safe patient care, efficient movement of patients and supplies, and workplace safety and security. The surgical suite includes the preoperative, intraoperative, and postoperative patient care areas and support areas, including central and satellite sterile processing areas, administrative areas, waiting areas, and staff areas. This document provides guidance on the design layout and equipment used in the surgical suite and maintenance of these spaces, as well as recommendations for functionality, energy and cost efficiency, workflow, and emergency measures; physical security measures; considerations and safety measures for new construction or renovation of the surgical suite; planning for unintended utility service interruptions; restoration of the surgical suite to full functionality; maintenance of structural surfaces; and the design, monitoring, and maintenance of the heating, ventilation, and air conditioning [HVAC] system.

The following topics are outside the scope of this document:

  • use of portable/robotic room decontamination equipment (See the AORN Guideline for Environmental Cleaning1 );

  • pathogen-specific (eg, SAR-CoV-2) infection prevention controls;

  • management of movable medical devices used in the OR (eg, bar coding; heater-cooler units [See the AORN Guideline for Sterile Technique2 ]);

  • forced-air warming devices [See the AORN Guideline for Prevention of Hypothermia3 ]);

  • accommodations for persons with disabilities;

  • workflow design and personnel preparation for a natural disaster or other emergency (eg, an active shooter);

  • general interior design concepts (eg, colors, furniture, cabinetry);

  • control of surgical smoke (See the AORN Guideline for Surgical Smoke Safety4 ); and

  • security of health information technology, including telehealth, patient-monitored technology (eg, ambient intelligence), and paper and electronic health records (See the AORN Guideline for Patient Information Management5 ).

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