Introduction: Surgical site infections (SSIs) are noteworthy, unfortunate, and costly complications of surgical procedures that may result from complex and multi-factorial causes. A number of questions still remain regarding the most effective way to cover the surgeon’s head to prevent SSIs. We investigated the use of bouffant as a proper surgical garb worn by the surgeons and other OR personnel to minimize the shed of bacteria and decrease the risk of SSIs.

Methods: Data was acquired from the hospital census records on SSI from January 2014 to March 2016. Based on the change of hospital policy, mandating obligatory use of bouffant since February 2015, data was categorized into non-bouffant and bouffant groups. Monthly and cumulative infection rates for thirteen months before and after the implementation of hospital policy were collected and analyzed for the non-bouffant and bouffant group, respectively.

Results: The mean of monthly rate of SSI in all Class I OR cases increased from 0.79±0.44 to 0.85±0.42 after the mandatory use of bouffant was implemented. However, this increase was not statistically significant (p=0.75). Similarly, the mean of monthly rate of SSI in all spinal procedures increased from 0.82±0.73 to 0.88±0.91 when bouffant was used by OR personnel (p=0.54). An overall increase of 0.07% (0.77% to 0.84%) in the cumulative rate of SSI in all Class I OR cases and of 0.03% (0.79% to 0.82%) in the cumulative rate of SSI in all spinal procedures was noted. However, both of these increases did not reach statistical significance (p>0.05).

Conclusions: Heeding published recommendations on hair coverage should help minimize the incidence and risk of SSIs, however, preliminary data shows that choice of headwear does not appear to influence the SSI rates.

Patient Care: This study focuses on improvements in surgical attire in order to decrease the post-operative surgical site infections and hence, improve patient care.

Learning Objectives: 1) Use of headwear in the operating room is necessary to decrease bacterial shed 2) The choice of headwear does not influence the rate of SSIs

References: Available upon request. Contact hshallwani@ubns.com