Design, devices, and discipline in operating room infection control.

The prevention of surgical infection in the operating theatre is a complex pursuit. Every facet of activity, whether it is part of the surgical act itself or a remote activity with indirect effects on the surgical operation, constitutes part of the whole realm of infection control. These many facets may be divided into four main components, all interdependent: (a) the surgeon and his team (surgical technique; adherence to surgical anatomic, physiologic, and aseptic principles; discipline); (b) education and communiction--a functioning infections committee, repeated tutorials for all prefessional and technical operating room personnel, constant review of methods and systems, effective reporting of offenses, enforcement of discipline; (c) dependable support services--sterilizing techniques, barrier materials, apparel, laundry methods; materials handling and processing methods; efficiency and personal hygiene of all techincal and support personnel; discipline; and (d) environmental factors--architecture, engineering, and air handling; electrical and mechanical requirements; communication; discipline).