Tip the Hat: Does A Superior Cloth Surgeons Cap ReallyExist? by Jason Nealy in Surgery & Case Studies Open Access Journal in Lupinepublishers
The efficacy of operating room headwear has been in debate
for several years as governing organizations, including the Joint
Commission, CDC, and the Association of Perioperative Registered
Nurses, have published guidelines without clear evidence in
support of these practices. In the 2016 edition of the Association
of Perioperative Registered Nurses Procedure Manual all operating
room personnel are to wear disposable bouffant-style hats. Several
studies have suggested that hair is a vehicle for bacterial dispersal,
however, there has been no definitive evidence that connects
bacteria in the hair to surgical site infections. In November, 2017
an article was published in the Journal of the American College of
Surgeons entitled “Hats Off: A Study of Different Operating Room
Headgear Assessed by Environmental Quality Indicators.” Though
this study has demanded criticism by those in control of OR policy,
it is not without validity. When assessing cloth skull caps, there was no difference in
terms of microbial or particulate shedding compared to disposable
skull caps, and lower particulate shedding compared to disposable
bouffant caps. This suggests that cloth skull caps are superior to
bouffant hats. In determining OR headwear an additional option
exists, one that has not been so publicly scrutinized: antimicrobial
cloth skull caps. To this date no studies have compared antimicrobial
cloth skull caps to regular cloth skull caps. We hypothesized that
antimicrobial skull caps will harbor less bacterial burden then
regular cloth skull caps. Antimicrobial cloth skull caps were purchased from Dickies, hat
serial code 83566A titled “Adult’s Antimicrobial Scrub Hat”. These
are unisex caps with ties in the back. They contain Certainty™
antimicrobial fabric technology. The EPA-registered antimicrobial
fabric technology in Certainty™ inhibit and minimize the growth of
unwanted microorganisms on the fabric through a polymer deliver
system of silver ions into the fibers of the fabric. It is a well-known
fact that silver ions and silver-based compounds are highly toxic
to microorganisms. Regular cloth caps were purchased new and
100% cotton, unisex fit, with ties in the back.
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