Prevention of infection in operating theatres

A bacteriological study of the immediate environment of a surgical wound

In an attempt to assess the importance of different aspects of the immediate wound environment during an operation, detailed bacteriological data were obtained in the operating theatre from 1000 patients operated upon in two different theatres.

Nasal and skin carriage of Staphylococcus pyogenes were found to be associated with a small number of autogenous infections, but no significant increase in the staphylococcal wound infection incidence could be shown in these groups. Skin carriage of other pathogens seemed to be of no importance with the disinfection methods used in the present study.

Settle-plate studies showed no apparent difference in the bacteriological hazard of the two operating theatre environments, neither appearing to constitute any real danger. Samples at the end of operation confirmed the importance of endogenous contamination with intestinal organisms during potentially dirty operations. Apart from the few autogenous infections, there was little evidence of staphylococcal wound sepsis arising as a result of contamination in the operating theatre. Hands and masks of members of the operating team could not be demonstrated as sources of contamination during operation.

There was no apparent difference in the bacteriological findings as they related to the different operating theatre environments.