The association of noise and surgical-site infection in day-case hernia repairs.
BACKGROUND
Surgical-site infections (SSIs) are associated with an increased duration of hospital stay, poorer quality of life, and an marked increase in cost to the hospital. Lapses in compliance with aseptic principles are a substantial risk factor for SSI, which may be attributable to distractions such as noise during the operation. The aims of this study were to assess whether noise levels in the operating room are associated with the development of SSI and to elucidate the extent to which these levels affect the financial burden of surgery.


METHODS
Prospective data collection from elective, day-case male patients undergoing elective hernia repairs was undertaken. Patients were included if they were fit and at low risk for SSI. Sound levels during procedures was measured via a decibel meter and correlated with the incidence of SSI. Data analysis was performed with IBM SPSS (IBM, Armonk, NY).


RESULTS
Noise levels were substantially greater in patients with SSI from time point of 50 minutes onwards, which correlated to when wound closure was occurring. Additional hospital costs for these patients were £243 per patient based on the National Health Service 2013 reference costing.


CONCLUSIONS
Decreasing ambient noise levels in the operating room may aid in reducing the incidence of SSIs, particularly during closure, and decrease the associated financial costs of this complication.
Milton Keynes General Hospital, Buckinghamshire, United Kingdom. Electronic address: sham.dholakia@nhs.net.
Shamik
S
Dholakia
Milton Keynes General Hospital, Buckinghamshire, United Kingdom.
John Paul
JP
Jeans
Milton Keynes General Hospital, Buckinghamshire, United Kingdom.
Usman
U
Khalid
Milton Keynes General Hospital, Buckinghamshire, United Kingdom.
Shruti
S
Dholakia
Milton Keynes General Hospital, Buckinghamshire, United Kingdom.
Charlotte
C
D'Souza
Milton Keynes General Hospital, Buckinghamshire, United Kingdom.
Kristof
K
Nemeth
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D004777:Environment; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D009622:Noise / Q000009:adverse effects* / Q000517:prevention & control; D061646:Operative Time; D011446:Prospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult