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Purpose   Surgical lights in the operating rooms are typically installed in a single axis in the center of the room or in two axes on both sides of the operating table. In the single-axis installation, the air-conditioning outlet cannot be placed in the center of the ceiling, which may affect the air current. Therefore, we measured the air current and cleanliness in two equivalent operating rooms using a vertical laminar airflow system equipped with either single-axis or double-axis surgical lights.Methods   Air current was measured using a three-dimensional ultrasonic anemometer. Cleanliness was evaluated by measuring the amount of dust before and after air-conditioner activation. To visualize the air current, smoke was illuminated on a sheet of laser light while the air-conditioning was stopped, and changes after air-conditioning activation were observed.Results   In the single-axis room, an oblique fast air current flowing from the surrounding air outlet toward the center was observed, and the flow velocity fluctuated greatly. In the double-axis room, uniform downward laminar airflow was observed. The amount of dust at the center decreased significantly faster in the double-axis room; thus, the cleanliness at the center was higher in the double-axis room. Persistent stagnation of smoke was observed below the single-axis lighting, whereas smoke below the double-axis lighting was immediately dispersed and the air cleared even when surgical lights were in the position for surgery.Conclusion   Uniform vertical laminar airflow was formed and high cleanliness was achieved in the center of the room when the surgical lights were arranged in two axes.

Influence of the Arrangement of Surgical Light Axes on the Air Environment in Operating Rooms