Fellows and Observers Are Not a Problem for Infection in the Operating Rooms of Teaching Centers

Purpose: The aim of the present study was to determine whether the risk of complications increases with the number of people in the operating room (OR). Several studies have stated that an increased number of people in the OR increases not only the risk of infection but also the risk of intraoperative complications due to distractions during the surgery. Materials and Methods: This retrospective study included all patients who had surgery between January 2017 and January 2018 in an OR with the usual surgical team and three or more observers. Patient demographic data, surgical details (duration of the surgery, the surgery being open or arthroscopic, and whether a graft was used), and intraoperative and postoperative complications were recorded. Results: A total of 165 surgeries were recorded, with a mean operating time of 70 min (40% open surgeries, 37% arthroscopic surgeries, and 23% combined open and arthroscopic procedures). The main intraoperative complications were vessel damage, nerve damage, premature cement setting, and leg-length discrepancy, with 1 case each. The main postoperative complications were rigidity (8 cases), unexplained pain (11 cases), failed meniscal suturing (3 cases), a postoperative stress fracture (1 case), correction loss in osteotomy (1 case), and wound problems not related to infection (1 case). There were no cases of infection. Discussion: The present study shows that the complication rate when having observers in the OR is comparable to the reported data. The key to avoiding complications is for everyone to comply with basic OR behavior.