Which is the best type of scrub caps for preventing surgical site infections
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The prevention of surgical site infections (SSI) has long been a focus for surgeons, particularly in controlling air contamination and the shedding of microorganisms from healthcare personnel in the operating room. With the introduction of laminar flow systems, modern operating rooms have made significant strides in air purification, which is crucial for reducing bacterial load and preventing SSI.
The Role of Surgical Caps and Research
In controlling the shedding of microorganisms from healthcare personnel, wearing sterile gloves, surgical gowns, masks, and surgical caps is essential. Surgical caps not only protect patients but also help reduce the transmission of microorganisms from the hair and skin of medical staff. However, differing opinions have emerged regarding the choice of surgical caps in recent years.
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- Disposable Bouffant Surgical Cap
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- Cloth Surgical Cap
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- Disposable Skull Surgical Cap
Types of Surgical Caps
- Disposable Bouffant Surgical Caps
- Skull Caps (or Non-Bouffant Caps)
- Fabric Surgical Caps
Research indicates that while bouffant surgical caps cover a larger area, they do not outperform skull caps in preventing microbial shedding. In fact, studies have shown that bouffant caps may lead to more microbial shedding in sterile areas. Specific findings include:
- There is no significant difference between disposable bouffant surgical caps and skull caps in blocking particles and bacterial contamination.
- Bouffant surgical caps showed a higher rate of microbial shedding in air tests compared to skull caps.
Additionally, compared to fabric skull caps, disposable bouffant surgical caps have a more severe shedding of 0.5 mm and 1.0 mm particles, as well as a higher rate of microbial shedding.
Visually, the quantity of bacteria in the petri dishes, from left to right, is as follows: disposable bouffant surgical cap, disposable skull cap, and fabric skull cap.
Comparing colony-forming units, from left to right, we have: disposable bouffant surgical cap, disposable skull cap, and fabric skull cap (the data shows that the colony-forming units of the disposable bouffant surgical cap are significantly higher than the latter two, while there is no significant difference between the latter two).
- Bouffant caps have larger pore sizes and higher permeability, resulting in poorer performance in filtering bacteria.
Surgeons’ Reactions
Surgeons expressed dissatisfaction with the recommendation to wear bouffant surgical caps, arguing that it affects their professional image and identity. In September 2016, a Boston Globe article highlighted a disagreement between the American College of Surgeons (ACS) and the Association of periOperative Registered Nurses (AORN) on this issue, sparking widespread discussion.
Conclusion
In summary, while bouffant surgical caps may appear more aesthetically pleasing, they do not demonstrate a clear advantage in preventing SSI based on research findings. Therefore, when selecting surgical caps, it is important to consider their actual protective effectiveness rather than just their appearance. Surgeons should continue to focus on evidence-based practices to ensure patient safety and treatment efficacy.
