Prevention and control of nosocomial infection (focus on the operating room), the concept of sterility and the application of antibiotics: The operating room is designed as a one-way pathway, where entry and exit are different routes. And for infected or suspected infected surgeries, after finishing the surgery the surgeon needs to change shoes at the door of the operating room and change clothes again in the dressing room before continuing the next surgery. Usually for orthopedic surgery, the procedure of aseptic operation is as follows: depending on the type of hand sanitizer, the exact time of hand washing and disinfection has been marked on, and there are tables above each operating room as an important tool for accurate control of hand hygiene. After the completion of hand washing and disinfection, the initial disinfection is performed by the assistant who is not wearing a surgical gown, then the second disinfection is performed by the first assistant who is wearing a surgical gown wearing double gloves, and finally the outer layer of gloves is changed after the sterile towel sheet is laid, and then the gloves are replaced. All C-shaped arms and navigation are equipped with sterile sleeves during the operation. And all surgical gowns are 360-degree enclosed surgical gowns, and all chairs including those used are added with sterile covers, so the front and back of surgical gowns in Germany can be considered sterile. And even for the usual ward check, professors and attending physicians have to spray their hands with disinfectant after each examination or check on a patient before they can see the next patient. It is because all health care workers have a strong sense of sterility that doctors in Germany usually do not rely very much on antibiotic treatment, so the application of antibiotics in Germany is quite standardized. First of all, the patient does not have a prescription and cannot buy antibiotics from the pharmacy; furthermore, from the operation specification, for ordinary joint replacement patients, one time is used during the induction of anesthesia, one additional time during the operation over 3 hours, and one day at most for postoperative antibiotics; for patients with joint infection revision, the maximum application of antibiotics is usually no more than 2 weeks (some large hospitals in China have to apply about 3 months, it is hard to imagine that there is such a huge difference between us It is hard to imagine that there is such a huge difference between us). The anesthesiologists are very good and it is commonplace for them to work with babies as young as seven days old to old ladies in their nineties. Usually patients in joint replacement or revision surgery are maintained in a hibernation state of hypothermia, low heart rate, and low blood pressure, and anesthesia is not used except for the application of isoproterenol during the induction period of anesthesia. Giving anesthesia to a newborn baby The entire orthopedic surgeon is a day of surgery from the morning, and it is worth mentioning that they are usually NO REAL, and of course after the surgery is over until another surgery starts, they can take a break room and have some coffee after dictating the recorded surgery. At lunchtime the nurses eat a salad or lunch that they bring with them, while the doctors usually eat soup and bread that are provided free of charge. Sometimes there is even a Bavarian specialty of kielbasa. The German outpatient clinics, wards and operating rooms have many concepts that we should learn from, such as the X-ray protection for doctors and patients. In each operating room, in the operating room recording compartment, in the outpatient room, in the physician’s office, there are advanced computer terminals everywhere to access the case data at any time; and then the environmental awareness of medical waste disposal (Germany medical waste classification is more strict than domestic waste classification!) For example, the protection of the surgeon’s eyes and skin includes surgical goggles and a variety of hand sanitizer options, and the classification of clothes and shoes in the operating room (easy to choose and save).