Description
What is the evidence behind the things we are forced to wear in the OR? Do they help? Are they voodoo?
On this episode, Karl takes us through the evidence behind the different pieces of OR attire. Some things seem to work... some things do nothing... some things might actually be harmful. 🤨
Literature Referenced:
Overview of adoption of OR attire through history, by examining historical photographs.
Adams, L., Aschenbrenner, C., Houle, T., Roy, R. (2016). Uncovering the History of Operating Room Attire through Photographs. Anesthesiology 124(1), 19-24. https://dx.doi.org/10.1097/aln.0000000000000932
Case report of surgeon performing appendectomy on himself.
Rogozov, V., Bermel, N. (2009). Auto-appendectomy in the Antarctic: case report BMJ 339(dec15 1), b4965-b4965. https://dx.doi.org/10.1136/bmj.b4965
An experimental study of how clothing effects the dispersal of staph.
Hill, J., Howell, A., Blowers, R. (1974). EFFECT OF CLOTHING ON DISPERSAL OF STAPHYLOCOCCUS AUREUS BY MALES AND FEMALES The Lancet 304(7889), 1131-1133. https://dx.doi.org/10.1016/s0140-6736(74)90885-x
First experimental study on surgical draping.
Beck, W., Collette, T. (1952). False faith in the surgeon's gown and surgical drape The American Journal of Surgery 83(2), 125-126. https://dx.doi.org/10.1016/0002-9610(52)90196-7
RCT including cloth vs. paper drapes for CABGs.
Bellchambers, J., Harris, J., Cullinan, P., Gaya, H., Pepper, J. (1999). A prospective study of wound infection in coronary artery surgery European Journal of Cardio-Thoracic Surgery 15(1), 45-50. https://dx.doi.org/10.1016/s1010-7940(98)00255-3
Cochrane review on using plastic adhesive drapes.
Webster, J., Alghamdi, A. (2015). Use of plastic adhesive drapes during surgery for preventing surgical site infection Cochrane Database of Systematic Reviews 4(4), CD006353. https://dx.doi.org/10.1002/14651858.cd006353.pub4
Disposable gowns have less infectious risk than multi-use gowns.
Moylan, J., Kennedy, B. (1980). The importance of gown and drape barriers in the prevention of wound infection. Surgery, gynecology & obstetrics 151(4), 465-70. https://www.ncbi.nlm.nih.gov/pubmed/7414454
Large study of the effect of using jackets on surgical site infections (spoiler: none).
Stapleton, E., Frane, N., Lentz, J., Armellino, D., Kohn, N., Linton, R., Bitterman, A. (2019). Association of Disposable Perioperative Jackets With Surgical Site Infections in a Large Multicenter Health Care Organization JAMA Surgery 155(1), 15-20. https://dx.doi.org/10.1001/jamasurg.2019.4085
Association of mouth flora with surgical site infections
HAMILTON, A. (1905). DISSEMINATION OF STREPTOCOCCI THROUGH INVISIBLE SPUTUM.IN RELATION TO SCARLET FEVER AND SEPSIS. JAMA: The Journal of the American Medical Association XLIV(14), 1108. https://dx.doi.org/10.1001/jama.1905.92500410032001g
First study testing the association of using masks and surgical site infections.
Orr, N. (1981). Is a mask necessary in the operating theatre? 63(6),
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