There’s an interesting (but very small) pilot study in the British Journal of Surgery that examines the relationship between operating room noise and surgical site infection (SSI) rates. A Swiss group--which previously correlated a subjective perception of increased noise with SSI--measured sound levels in 35 ORs during elective abdominal operations. Median sound levels were significantly higher during cases of patients who subsequently developed SSI (43.5 dB vs. 25.0 dB, p=0.04). Also of note: talking about non-surgery-related topics was associated with higher sound levels, and sound levels increased about 60 minutes after incision. Since we already know that SSI risk increases with the duration of a procedure, it may be that longer surgeries are also associated with more, and louder, non-surgical conversations as the team becomes bored or distracted (though not statistically significant, the procedure duration was longer for SSI patients in this study (mean of 390 vs. 255 minutes)). And as the authors note, higher sound levels could simply reflect the difficulty of a procedure (suction machines, alarms, louder and longer conversations, primal screams, etc.). Future studies could help determine if higher OR sound levels are just markers for difficult, stressful cases, or if more noise negatively affects surgeon performance (or both!).
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