Rituals and behaviours in the operating theatre and preventing infection. Using the evidence and consensus opinion to provide practical advice

There are existing evidence-based procedures and interventions undertaken pre- and peri-operatively to minimise surgical site infection (SSI), e.g. pre-operative surgical prophylaxis and minimising hypothermia. However, there are also many rituals and behaviours that take place in operating theatres (OT), that are derived from tradition, and custom rather than from evidence. To optimise patient care and efficiency in the use of resources, clinical guidelines are needed that are supported by whatever evidence is available. However, where there may be a degree of uncertainty regarding this evidence base, any advice that we or others provide should be characterised by integrity and a degree of humility.