 In a previous study, the investigators established an empirical relationship between communication during surgery and SSI was shown in a prospective observational study in 167 patients undergoing major elective open abdominal procedures. An analysis of 11383 communication events observed by a team of trained work psychologists showed a relationship between intraoperative communication and SSI. Adjusted logistic regression analysis revealed that more case-relevant communication during the entire procedure was associated with a significant reduction in organspace SSI odds ratio 0.861, 95 confidence interval 0.750-0.987; P0.034. Interestingly, case-irrelevant communication during the last 20 minutes of the procedure was associated with a significant increase of incisional SSI odds ratio 1.1153, 95 confidence interval 1.040-1.196; P0.002. Distractors such as noise and traffic were also assessed but had no effect on SSI. The current study is based on these observations, which reveal that case-relevant communication protects from organspace SSI and case-irrelevant communication during the last 20 minutes of the procedure is a risk factor for SSI. 