Hygiene in the operating room. Can everyone do as they wish?

Background. Every postoperative wound infection means a serious complication for the patient that can affect the rest of his/her life. For instance, a good endoprosthesis is a blessing for every patient, while an infectious course is catastrophic. For these and medicolegal reasons, continuous records of wound infections are indispensible in traumatology and endoprosthetics. Prevalence of wound infections. In an international comparison, Germany does not occupy the best possible position. While the mean infection rates in Scandinavia are around 0.5% (Scandinavian Hip Register) and similar figures are also found in the Netherlands, the KISS study in Germany revealed figures of around 1.95% with a high estimated number of unreported cases of up to 4% ["KISS Studie zur Erfassung von Wundinfektionen" (http://www.nrz-hygiene.de/dwnld/referenzop.pdf)]. Hygiene. Because the implants in the various countries are comparable and equipment levels in German operating theatres are ideal, we must ask ourselves the question whether a false understanding of hygiene might be the cause of these poor results. Hygiene not only demands discipline from all the parties involved in an operation, hygiene also costs money. Although financial resources are growing ever sparser, the resulting consequences must not lead to any reduction in hygiene. The early symptoms have already been registered. Therefore, the Hygiene Working Party of the Scientific Medical Specialist Organisations Project Group ("Arbe-itsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaften", AWMF) has written a core statement for guidance that includes the following key sentence: Key sentence. "Since every patient has a right to faultless medical care that is also state of the art in matters of hygiene, compliance with the hygienic necessities has absolute precedence over economic requirements which must never be allowed to endanger patients or staff" (AWMF-Leitlinienregisternummer 029/038).