Hand Surgical Operating Room Size Allocation: A Comparative Space Utilisation Study

Background: This study evaluated operating room (OR) space required for various hand surgical procedures. We analysed the size requirements for hand surgical cases divided into four settings: (1) large OR setting requiring fluoroscopy and microsurgical equipment, (2) medium-sized OR setting for cases requiring fluoroscopy, (3) smaller OR setting and (4) minor procedural room without anaesthesia with the aim to describe room size requirements for hand surgery practices. Methods: A variety of hand surgical cases were selected: large cases (microvascular digit replantation), medium-sized cases (closed reduction percutaneous pinning [CRPP] of phalangeal fractures) and smaller cases (carpal tunnel release [CTR]) with and without anaesthesia. Space requirements were compared to general surgery cases (laparoscopic appendectomy) and general orthopaedic surgery cases (cephalomedullary nail [CMN]). Necessary operative equipment was measured (ft²) to calculate requirements for each procedure. Results: Large hand cases such as digit replantation necessitated the most OR space (125 ft²), followed by general orthopaedic cases (CMN; 118 ft²), medium-sized hand cases (CRPP phalanx; 107 ft²), general surgery laparoscopic appendectomy (68 ft²), small hand cases (CTR; 85 ft²) and minor procedures (49 ft²). Conclusions: Hand procedures can be divided into major procedures requiring significant OR space (125 ft²), medium procedures in standard OR suites (107 ft²), procedures in small ORs with anaesthesia (81 ft²) or office-based setting without anaesthesia (49 ft²). These findings help define space utilisation for hand procedures and may have practical implications related to efficiency, cost and patient safety in the hospital and outpatient setting. Level of Evidence: Level IV (Economic and Decision Analyses).