Testing a Minimal Three-Zone Surgical Setup Under Infrastructure-Degraded Conditions

Infrastructure degradation during conflicts and disasters may necessitate temporary surgical capability in improvised environments lacking conventional operating-room infrastructure. We operationally evaluated a minimal 3-zone surgical setup consisting of a contaminated dirty zone (12 m²), a semiclean transition zone (15 m²), and a protected procedural core (14 m²). Workflow simulations demonstrated reproducible separation of patient, personnel, material, and waste flows within a total operational footprint of 41 m². Spatial demand was primarily determined by contamination control, workflow separation, and procedural movement geometry.