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There are, broadly, two ways of controlling post-operative staphylococcal wound sepsis. One is to take every possible precaution against every conceivable mode of infection. Attempts to do this are undoubtedly effective, and it is sometimes the only way of dealing quickly with a severe outbreak. But it is expensive of time, money, and temper and is so tedious that when the emergency is over, its complicated routine tends to degenerate into an ineffective ritual. Another defect of this method is that it encourages the expenditure of great effort on exotic precautions for no better reason than that someone has a bee in the bonnet about them. The other approach along which, one hopes, we are steadily moving is to determine the importance, under existing conditions, of each possible source or mode of infection and then to apply new or improved precautions against those that matter.In this paper we report studies on the roles of the patients themselves (selfinfection), and of the surgical team (cross-infection) as sources of staphylococci causing post-operative sepsis.Self-infection has been recently much studied, with rather conflicting results.It has, however, been generally found that about half the cases of wound sepsis are caused by Staphylococcus aureus of the same phage type as that carried, before operation, in the patient's nose. This indicates that the nose may be an important source from which the wound is often infected; but it could mean no more than that hospitals are infested by staphylococci which, independently, infect noses and wounds. In some surveys, the former explanation was favoured by the finding that patients who were nasal carriers of Staph. aureus suffered sepsis much more often than those who were not carriers. In other surveys, however, this difference between carriers and non-carriers has been less evident or even absent. Moreover, patients whose nares are kept free of staphylococci by application of antibacterial creams suffer no less sepsis than untreated controls.

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