NSQIP: Effect of modifications to OR attire on SSIs

Editor's Note

Implementation of stringent OR attire policies that include full coverage of ears and facial hair do not reduce surgical site infection (SSI) rates, finds this study.

Researchers compared National Surgical Quality Improvement Program (NSQIP) data from all patients having surgery 9 months before implementation (3,077) to 3,440 patients having surgery 9 months after implementation of the stringent policies.

There were more SSIs after implementation of the policies (33 vs 30), and there were no differences in length of stay, complications, or mortality.

The largest predictors of SSIs were preoperative infection, operative time > 75^th percentile, open wounds, and dirty/contaminated wounds.

Patients who underwent surgery before or after implementation of strict operating
room attire regulations revealed no reduction in surgical site infections. Power analysis
demonstrated that nearly 500,000 patients (number needed to treat=1,429) would be
required to prove a 10% reduction in surgical site infections among patients with
clean or clean-contaminated wounds.

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