Surgical site infection is one of the most feared complications in outpatient surgery. It is also one of the most preventable — but only with sustained attention, layered protocols, and the willingness to invest in tools that most facilities of our size do not.

We use UV-C germicidal light in every room of our facility. Patient rooms, patient bathrooms, our operating room, and the back processing rooms where instruments are prepared for the next case. This is in addition to — never instead of — the standard mechanical cleaning that every accredited surgical facility performs between cases.

UV-C is short for ultraviolet-C, a specific wavelength of ultraviolet light (around 254 nanometers) that has been used in medical and industrial settings for nearly a century for one reason: it inactivates the vast majority of bacteria, viruses, and fungi that come into contact with it. It works by damaging the genetic material inside microorganisms, so they cannot replicate. Hospitals use it. Wastewater treatment plants use it. Some HVAC systems in offices use it. What is unusual is finding it in a surgery center our size.

We chose to invest in UV-C because standard cleaning, however well executed, has limits. Manual disinfection depends on the person doing it — the surfaces they reach, the amount of time they leave disinfectant in contact with each surface, the specific solution they use for the specific pathogen. There is always some percentage of surface area, some corner of the room, some piece of equipment, that receives less than perfect coverage. UV-C addresses that gap. In an empty room with the doors closed, a UV-C cycle reaches every surface the light can touch — every corner, every countertop, every piece of equipment, every square inch of floor — and reduces microbial load by orders of magnitude beyond what manual cleaning alone achieves.

The critical word is "empty." UV-C is powerful because it is high-energy light, and the same property that makes it germicidal makes it harmful to human skin and eyes. UV-C cycles run when the room is unoccupied — between cases, at the end of the day, and after any procedure with elevated infection risk. Our staff never enter a room during a UV-C cycle. This is a limitation, not a hidden risk — it is why UV-C supplements manual cleaning rather than replaces it.

We track our infection rate the way every accredited surgical facility is required to, and we report it as part of our AAAHC accreditation. Our rate remains well below the national benchmark. Multiple factors contribute — physician anesthesia on every case, our scheduling model that never rushes turnovers, our team's experience, and the surgeons we affiliate with — but the UV-C protocol is a piece of that broader picture, one we chose to add because the arithmetic on infection prevention is straightforward: every additional layer, executed correctly, reduces risk. Layers compound. There is no elegant single solution to something as consequential as surgical infection, so we build layers.

Most patients never notice this. UV-C cycles happen behind closed doors. Instruments arrive to the operating room already sterile through standard sterilization processes; UV-C doesn't touch them. The room a patient is admitted to has been UV-C cycled after the last patient departed, mopped, wiped down, and cycled again before their arrival. This is all invisible.

We're writing about it now because it is worth knowing. When you choose a surgical facility, the specific protocols matter more than the brochure. If a patient is comparing centers, we would want them to ask the question at every one of them: what do you do beyond standard cleaning? Our answer has been the same for years — we run UV-C in every room, and it is one of the reasons our numbers stay where they do.

H. Rand Scott, MD is founder and Medical Director of Newport Center for Special Surgery. Board-certified anesthesiologist, subspecialty training in interventional pain management at Penn State Milton S. Hershey Medical Center. He personally offers a free Rest-Assure pre-operative consultation to every scheduled surgical patient at NCSS.