Operating theatre etiquette, sterile technique and surgical site preparation

The operating theatre is an unusual environment and understanding the systems in place there is an important part of surgical training. ‘Non-technical skills’ is a term used to describe everything a surgeon does in the operating theatre, other than the technical aspects of the procedure itself. This includes communication, decision making and leadership. Non-technical skills have become a vital aspect of the development of a surgeon and should form part of training programmes. A fundamental responsibility of the surgeon is the maintenance of sterility. The techniques of the surgical scrub and preparing and draping a patient only become second nature after good teaching and reflection by the surgeon. The purpose of this article is firstly to describe how a surgical trainee can get the most out of an operating session. We will describe what non-technical surgical skills are and why they are important. We will focus on safety in the operating theatre and discuss worldwide strategies such as the ‘Surgical Safety Checklist’ that aims to improve this. Finally we will present data on measures to reduce surgical site infection, such as which surgical scrub solution to use and whether drapes or wound protectors work.