BACKGROUND: Infection control is a critical aspect in the continuum of surgical 
care. Much of what is outlined in the literature pertains to hospital-based 
practice, with only recent attention paid to the more austere environments, 
particularly those faced during humanitarian or combat operations.
OBJECTIVE: This manuscript provides a brief historical review of the development 
of infection control practices and further identifies and outlines several 
aspects necessary to successful program applications in austere environments.
RESULTS: Hand hygiene remains the simplest form of infection control. Use of 
alcohol-based hand sanitizer is a logistically reasonable option for most 
circumstances, mitigating the requirement for clean running water to facilitate 
more traditional "soap and water" methods of hand disinfection. Environmental 
decontamination, patient cohorting, and patient isolation based on existing 
colonization/infection also has demonstrated efficacy in controlling 
cross-contamination and is feasible in most austere environments. Finally, 
senior leadership engagement with deliberate planning, antimicrobial 
stewardship, and vigorous quality and process improvement algorithms have 
resulted in reduced rates of critical infections in these settings.
CONCLUSIONS: Basic tenets of infection control can be achieved even in 
resource-poor environments. Meticulous attention to adhering to these 
principles, with support from senior medical and operational leadership, 
facilitates improvements in infection control outcomes. There remains, however, 
a need for additional robust outcomes data regarding best practices in these 
environments.