title: Impact of case-relevant and case-irrelevant communication within the surgical team on surgical-site infection.
abstract: BACKGROUND
  Surgical-site infections (SSIs) are the most common complications after surgery. An influence from talking and distractions during surgery on patient outcomes has been suggested, but there is limited evidence. The aim of this prospective observational study was to assess the relationship between intraoperative communication within the surgical team and SSI, and between intraoperative distractions and SSI.
  
  
  METHODS
  This prospective observational study included patients undergoing elective, open abdominal procedures. For each procedure, intraoperative case-relevant and case-irrelevant communication, and intraoperative distractions were observed continuously on site. The influence of communication and distractions on SSI after surgery was assessed using logistic regressions, adjusting for risk factors.
  
  
  RESULTS
  A total of 167 observed procedures were analysed; their mean(s.d.) duration was 4·6(2·1) h. A total of 24 SSIs (14·4 per cent) were diagnosed. Case-relevant communication during the procedure was independently associated with a reduced incidence of organ/space SSI (propensity score-adjusted odds ratio 0·86, 95 per cent c.i. 0·77 to 0·97; P = 0·014). Case-irrelevant communication during the closing phase of the procedure was independently associated with increased incidence of incisional SSI (propensity score-adjusted odds ratio 1·29, 1·08 to 1·55; P = 0·006). Distractions had no association with SSI.
  
  
  CONCLUSIONS
  More case-relevant communication was associated with fewer organ/space SSIs, and more case-irrelevant communication during wound closure was associated with incisional SSI.
authors.affiliation: Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Bern, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Tschan
authors.affiliation: Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Bern, Switzerland.
authors.forename: J C
authors.initials: JC
authors.lastname: Seelandt
authors.affiliation: Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Bern, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Keller
authors.affiliation: Institute of Psychology, University of Bern, Bern, Switzerland.
authors.forename: N K
authors.initials: NK
authors.lastname: Semmer
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Kurmann
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Candinas
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Beldi
mesh_terms: D003142:Communication; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D066231:Surgeons; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D013557:Switzerland / Q000453:epidemiology