OPERATION THEATRE TRAFFIC AND ITS ASSOCIATION WITH SURGICAL SITE INFECTION RISK: A COMPREHENSIVE REVIEW

Abstract

Background: Surgical site infection (SSI) represents one of the most significant healthcare-associated infections (HAIs) responsible for 17–20% of all HAIs and is associated with morbidity, mortality and healthcare costs. Operation theatre (OT) traffic (movements of staff and openings of doors during surgical procedures) is the most consistently identified and modifiable risk factor known. In this review, the connection between staff traffic, OT door openings and incidence of SSI is considered.

Methods: A structured literature review was carried out in PubMed, Google Scholar, CINAHL and Cochrane Library. The twenty-nine studies that were identified, appraised and synthesized thematically between 2009 and 2025 focused on evaluating the relationship between intraoperative traffic (entry and exit of personnel, door openings) and the risk of SSI.

Results: Laminar airflow and positive pressure systems are disturbed, which raises the number of airborne bacteria in the vicinity of the sterile field by door openings and continuous OT traffic. Evidence has shown a relationship between increased OT traffic and increased SSI risk, as well as between each additional door opening for a specific increase in SSI risk. There was also a strong correlation between the cumulative door-open time and risk of infection.

Conclusion: OT traffic is a behaviour and environment factors that can be modified and has a significant effect on surgical field sterility. While more research with good quality is required in all surgical specialties, evidence today indicates that the adoption of measures to limit unnecessary staff movement and door openings is a strategy that has the potential to reduce the risk of SSI. Keywords: Airborne bacteria, infection control, surgical site infection, laminar airflow, healthcare, operating room.