title: Theatre shoes - a link in the common pathway of postoperative wound infection?
abstract: BACKGROUND
  Operating department staff are usually required to wear dedicated theatre shoes whilst in the theatre area but there is little evidence to support the beneficial use of theatre shoes.
  
  
  METHODS
  We performed a study to assess the level of bacterial contamination of theatre shoes at the beginning and end of a working day, and compared the results with outdoor footwear.
  
  
  RESULTS
  We found the presence of pathogenic bacterial species responsible for postoperative wound infection on all shoe groups, with outdoor shoes being the most heavily contaminated. Samples taken from theatre shoes at the end of duty were less contaminated than those taken at the beginning of the day with the greatest reduction being in the number of coagulase-negative staphylococcal species grown. Studies have demonstrated that floor bacteria may contribute up to 15% of airborne bacterial colony forming units in operating rooms. The pathogenic bacteria we isolated have also been demonstrated as contaminants in water droplets spilt onto sterile gloves after surgical scrubbing.
  
  
  CONCLUSIONS
  Theatre shoes and floors present a potential source for postoperative infection. A combination of dedicated theatre shoe use and a good floor washing protocol controls the level of shoe contamination by coagulase-negative staphylococci in particular. This finding is significant given the importance of staphylococcal species in postoperative wound infection.
authors.affiliation: Department of Trauma and Orthopaedics, Musgrove Park Hospital, Taunton, UK. ramirfeyz@yahoo.com
authors.forename: Rouin
authors.initials: R
authors.lastname: Amirfeyz
authors.forename: Andrew
authors.initials: A
authors.lastname: Tasker
authors.forename: Sami
authors.initials: S
authors.lastname: Ali
authors.forename: Karen
authors.initials: K
authors.lastname: Bowker
authors.forename: Ashley
authors.initials: A
authors.lastname: Blom
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D004739:England; D004866:Equipment Contamination; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D019637:Orthopedic Procedures / Q000295:instrumentation*; D010865:Pilot Projects; D012775:Shoes; D013530:Surgical Wound Infection / Q000382:microbiology*