Guideline Implementation: Surgical Attire

Abstract

Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

Mandatory Change From Surgical Skull Caps to Bouffant Caps Among Operating Room Personnel Does Not Reduce Surgical Site Infections in Class I Surgical Cases: A Single-Center Experience With More Than 15 000 Patients

“…It can be argued that surgical caps can be used as appropriate surgical headwear in lowrisk procedures as long as they are either disposable or laundered by industry standards in a healthcare-accredited laundry facility after daily use or when contaminated. 5,30 There was a statistically nonsignificantly lower rate of SSI at our institution when primarily disposable skull caps were used and cloth caps were also permitted. There may be a difference between disposable and cloth skull caps, however, that is beyond the scope of this study.…”

“…Rationale for Using Headwear in the OR Aerobic and anaerobic bacteria are constantly being shed and dispersed from the human body along with the normal desquamation of skin. 5,[14][15][16] Airborne contaminants from surgeons and medical staff are considered a major source of contagion in the OR, [17][18][19][20] thereby necessitating measures to prevent the spread of microbes causing SSI.…”

“…Although intrinsic patient factors can be difficult to control, extrinsic risk factors, such as microorganismal contamination and transmission in the perioperative setting, may be reduced by best clinical practices and procedures. 1,2,5 Proper surgical attire may be a key factor in providing a hygienic and commensurately sterile surgical environment. [1][2][3][5][6][7][8] Several studies and reviews have investigated the dos and don'ts of surgical attire in the operating room (OR), [1][2][3]6 including the use of a head cover by OR personnel.…”

“…1,2,5 Proper surgical attire may be a key factor in providing a hygienic and commensurately sterile surgical environment. [1][2][3][5][6][7][8] Several studies and reviews have investigated the dos and don'ts of surgical attire in the operating room (OR), [1][2][3]6 including the use of a head cover by OR personnel. [9][10][11][12] Nevertheless, numerous questions remain regarding the most effective way to cover the surgeon's head.…”

General Assembly, Prevention, Operating Room - Personnel: Proceedings of International Consensus on Orthopedic Infections

“…This, however, is against the recommendation of the Association of Peri-Operative Registered Nurses for OR personnel to wear bouffant caps. It should be considered that the outcome studied was contamination in vitro in comparison to actual surgical site infections (SSIs) seen in surgical patients [56].…”