One of the c-section patients from last week, returned with peritonitis last night and resulted in Holly and me questioning the sterility of the OR in its current state and have decided that the most appropriate first step is to address infection control.  Holly’s expertise as a scrub nurse and my perspective as a surgeon, with the local MD’s input have resulted in a new blueprint for the OR.  Holly and I spent all morning going through the available space, designating dirty, clean and sterile areas with patient flow, instrument use and processing, storage, etc. in mind.   This process revealed some disturbing findings including insect infestation and dried blood on previously “cleaned” items.   We initially were planning on operating on Monday, but I’ve cancelled that.  In fact, I’m doubting that we’ll be able to perform any operations during my time here.  Tomorrow was planned as a free day, but Holly and I are going to the OR for a few hours in the morning.   I’m praying that we will be able to make some good progress.