An evidence-based approach to infection control in the operating theatre

Abstract

The aim of operating theatre infection control is to minimise risk of surgical site infections (SSIs). The emergence of multi resistant micro-organisms and the increased awareness of appropriate antibiotic use have made the process of theatre infection control and its evidence base ever more relevant. Many theatre practices are widely accepted as ‘common sense’ measures and have become ‘ritualistic’ behaviours. However some practices have little, weak or inconclusive evidence to substantiate them. The multifactorial nature of SSIs means that no single measure is likely to completely eradicate risk and currently the exact nature of the raft of measures necessary requires further investigation. Hand disinfection of the operating team prior to surgery, wearing of sterile surgical gloves by ‘scrubbed’ personnel and disinfection of the surgical site have a strong evidence base and should be mandatory practices however the exact processes require a stronger evidence base. It is likely that the practice of wearing theatre ‘uniforms’ contributes to theatre discipline via behavioural attitudes rather than by specific SSI risk reduction. Future research in this area is also likely to further evaluate the growing evidence base in support of the use of triclosan-coated suture material to possibly reduce SSI.