Traffic, Attire, and Distractions in the Operating Room

The operating room (OR) is a complex and challenging workplace, and OR personnel face various hazards constantly. Traffic, attire, and distraction are all an integral part of the OR and play a crucial role in ensuring a safe and efficient working environment. The surgical suite is divided into three designated areas: the unrestricted, the semi-restricted, and the restricted. In principle, as we progress from the unrestricted to the restricted areas, regulations regarding the traffic of personnel and material, the appropriate attire, and the environmental control become stricter. In this chapter, we present the role of traffic as a predisposing factor for surgical site infections (SSIs). Then we present the literature’s controversies regarding our attire policies and summarize the current recommendations regarding attire in the OR. Increased OR traffic and inappropriate attire could aggravate SSI rates. Following the current guidelines could help reduce SSIs. Finally, we demonstrate how distractions in the OR could compromise surgical care quality and jeopardize patient safety. Surprisingly, most of our current practices reflect a continuation of historic practices rather than evidence-based ones. Nevertheless, current guidelines advocate for the enforcement of these practices, probably until high-quality evidence suggests otherwise. Therefore, myth and reality will most likely continue to coexist for the imminent future.