Background: Disinfection in operating rooms is crucial for preventing surgical site infections and ensuring patient safety. Advanced disinfectants, such as ultraviolet (UV) light, hydrogen peroxide vapor, and electrochemical disinfectants, have emerged as alternatives to traditional methods. While clinical evidence suggests potential benefits of these technologies, there remains a limited understanding of their overall effectiveness and the practical challenges of implementing them in hospital settings. This systematic review assesses the clinical efficacy of advanced disinfectants used in operating rooms and identifies key barriers to their widespread adoption in healthcare facilities. Materials and Methods: A comprehensive search was conducted across four databases: PubMed, Cochrane Library, Scopus, and Web of Science, covering records from their inception to November ۲۰۲۴. The search terms included "advanced disinfectants," "operating rooms," "surgical site infections," "UV disinfection," "hydrogen peroxide vapor," and "electrochemical disinfection." Studies were included if they evaluated advanced disinfectants in operating rooms and were published as randomized controlled trials, cohort studies, or case-control studies in English. Studies were excluded if they focused on non-clinical settings, lacked clear outcome measures on disinfection efficacy, or examined traditional disinfectants. The Cochrane Risk of Bias tool was used to assess the risk of bias in the included studies, and data synthesis was performed using a random-effects model. Results: The review analyzed eighteen studies involving a total of ۳,۵۰۰ participants. It focused on the effectiveness of three disinfectants in operating rooms: ultraviolet (UV) light (۸ studies), hydrogen peroxide vapor (۵ studies), and electrochemical disinfectants (۵ studies). A meta-analysis revealed that both UV light and hydrogen peroxide vapor significantly reduced the incidence of surgical site infections (SSIs) compared to traditional disinfectants, with a relative risk (RR) of ۰.۶۵ and a ۹۵% confidence interval (CI) of ۰.۵۲ to ۰.۸۲. Conversely, electrochemical disinfectants did not show a statistically significant effect, with an RR of ۰.۹۵ and a ۹۵% CI of ۰.۸۳ to ۱.۱۰. Furthermore, ۱۴ studies identified several implementation barriers, primarily characterized by high initial costs, technical complexities, and inconsistent adherence to disinfection protocols by staff. Conclusion: Advanced disinfectants, powerful UV light, and hydrogen peroxide vapor can significantly reduce surgical site infections (SSIs) in operating rooms. However, challenges related to costs, technology integration, and personnel training pose significant barriers to their widespread use in hospitals. It is essential to address these issues to improve the adoption of advanced disinfectant technologies in clinical practice.
