Effect of mandatory change from skull to bouffant caps on SSIs

Editor's Note

A mandatory change from surgical skull caps to bouffant caps in the OR did not reduce surgical site infections (SSIs), this study finds.

In this analysis of 15,000 class I (clean) surgical procedures performed 13 months before and 13 months after surgical skull caps were banned at a medical center with 25 ORs, there was a 0.07% increase of SSIs in class I procedures and a 0.03% increase of SSIs in spinal procedures. SSIs decreased from 0.95% to 0.75% in craniotomy/craniectomy procedures. None of the changes reached statistical significance.

National efforts at improving healthcare performance need to be evidence based, and guidelines, especially when applied in a mandatory fashion, should be assessed for effectiveness, the authors note.

Hussain Shallwani, MD, Hakeem J. Shakir, MD, Ashley M. Aldridge, Maureen T. Donovan, MSN, Elad I. Levy, MD, MBA, Kevin J. Gibbons, MD; 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.