What kind of surgical cap is better to wear to prevent surgical site infection?

What kind of surgical cap is better to wear to prevent surgical site infection?

Prevention of surgical site infection (SSI) has been a topic of concern to surgeons. In the operating room, controlling air pollution and shedding of microbes from medical personnel are important measures to prevent SSI.

For modern operating rooms, it is no longer difficult to control air pollution, especially the establishment of a laminar flow system, which can significantly purify the air and reduce the bacterial load, which is an important and effective measure to prevent SSI.

In terms of controlling the shedding of microorganisms on the surface of medical personnel, sterile gloves + sterile surgical gowns + masks + surgical caps are sufficient to prevent any microorganisms on the doctor’s body from falling off and contaminating the surgical area.

As a result, the standard “look” of the surgeon was shaped like this:

Figure 1: Sturdy surgeon Er, I’m sorry, I almost went off the topic …

The purpose of this article is to discuss the surgical cap.

Figure 2: Surgeon wearing a disposable edgeless surgical cap, capable + wise

Or this:

Figure 3: Putting on the cloth surgical cap you bought is still a charming year

However, some people feel that it is not perfect:

You see, the hair near the ears is exposed, and the hair can carry staphylococcus, streptococcus, and coryneform bacteria, especially the ears, forehead, and eyebrows, which have higher bacteria content. Therefore, this protection is not tight enough.

So, the following surgical cap appeared:

This time the surgeons are unwilling: the edgeless surgical cap is my signature feature. Wearing a fluffy surgical cap has affected my professional identity as a surgeon to some extent !

 

In September 2016, a Boston Globe article (seriously) mentioned that the American College of Surgeons (ACS) and the American Association of Perioperative Registered Nurses (AORN) differ on this point.

 

How to do it? They are not willing to concede each other, each with their own reasons, can not fight to solve the problem, right?

Under the modern medical concept that evidence must be said, the surgeon decided to come up with data and fight back with factual evidence. The researchers are Dr. Markel and others. The research results are published in the recent JACS journal to see the research design and its results.

The team tested disposable fluffy surgical caps and caps, as well as freshly washed cloth surgical caps. Tests include airborne particles and microbes in the surgical cap, permeability, particle penetration and pore size of the surgical cap.

Research shows:

 

1. Disposable fluffy surgical caps and disposable edgeless surgical caps have no significant difference in blocking particle and bacterial contamination.

2. The air test found that the fluffy surgical cap has more microorganisms falling off in the sterile area than the edgeless surgical cap. In addition, compared with cloth edgeless surgical caps, disposable fluffy surgical caps are more serious in terms of 0.5 mm and 1.0 mm particle shedding and microorganism shedding.

 

Figure 5: Visually see the amount of bacteria in the petri dish, from left to right: disposable fluffy surgical cap, disposable edgeless surgical cap, cloth edgeless surgical cap

Figure 6: Comparison of colony forming units, from left to right: disposable fluffy surgical cap, disposable edgeless surgical cap, cloth edgeless surgical cap (data show that the colony forming unit of the disposable fluffy surgical cap is significantly higher In the latter two, and there is no significant difference between the latter two)

3. The fiber analysis showed that the disposable fluffy surgical cap has a larger average and maximum pore diameter than the cloth surgical cap, and its permeability is significantly higher than that of the disposable and cloth edgeless surgical cap.

Then, the final conclusion of the study is: Compared with the edgeless surgical cap, the disposable fluffy surgical cap is more permeable, the particles are more penetrating, and the microorganisms are shedding more. Although the fluffy surgical cap covers more areas, it has no advantage in preventing bacterial contamination in the operating room.

Finally, despise hospitals that offer green surgical caps.

ACS: Are you convinced?

AORN ： ……