Much has been written about the various factors which cause or are thought to cause "cross infection" of wounds in hospital. In most investigations an individual problem such as theatre ventilation or the sterilisation of blankets has been studied in detail. The introduction of one such measure, although a step in the right direction, is unlikely to produce dramatic or permanent results. When, however, all the preventive measures which are known or thought to minimise "cross infection" are introduced simultaneously in one hospital one might expect a reduction in the incidence of infection of clean surgical wounds.
By improving theatre facilities, ward facilities and by providing sterile materials for operations and ward procedures, the incidence of infection of clean wounds has been reduced from 6.7% to 0.7 %.
It would appear that infection is most frequently introduced in theatre. If money is limited, priority should be given to theatre improvements and to the supply of sterile theatre instruments, dressings and fabrics.
A comparison of the results achieved in three surgical units would indicate that the "human element" is very important. One cannot eliminate bacteria unless the surgeon and his assistants can mentally visualise them.
The incidence of infection in surgical wounds must be recorded accurately. Phage typing of all staphylococcal infections will make the early detection and prevention of an epidemic of wound sepsis easier.
Prevention of wound sepsis is a team responsibility involving the entire hospital staff. Pathogenic bacteria cannot be eliminated from hospital. The war against sepsis cannot end. The team's effort must be planned, vigorous and continuous.