Intended for healthcare professionals

Feature Surgical Safety

Clean cut surgery

BMJ 2016; 353 doi: (Published 18 May 2016) Cite this as: BMJ 2016;353:i2686
  1. Jane Feinmann, freelance journalist, London, UK
  1. jane{at}

Jane Feinmann reports on a new initiative to reduce the incidence of infection after surgery

Infection of the surgical site, a major threat for all postoperative patients and a leading cause of hospital acquired infections, is a particular problem in low resource settings, where rates are double those reported in Europe and the United States.1 With no global approach to instilling best practice, it’s a problem that causes unnecessary morbidity and mortality and strains hospital systems and budgets.

Now Lifebox, the non-profit organisation chaired by American surgeon and author Atul Gawande, has aspirations to substantially reduce infections with a new technical programme. As with their ongoing work on safe anaesthesia, Clean Cut (checklist expansion for antisepsis and infection control—customisation, use, and training) uses the World Health Organization’s Surgical Safety Checklist to identify and overcome particular barriers that hospitals in low resource setting hospitals face in delivering safer surgical care. The WHO checklist has been shown to reduce risk of surgical complications and mortality by up to 40%.2

First developed by Gawande with a team of clinical and behavioural experts at WHO in 2009, the checklist requires surgical teams to take basic safety precautions, such as ensuring that blood is available …

View Full Text

Log in

Log in through your institution


* For online subscription