February 12, 2020

Association of surgical jackets, bouffant head covers with SSIs

By: Judy Mathias
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Editor's Note

Long sleeved surgical jackets and bouffant head covers are neither beneficial nor cost-effective in preventing surgical site infections (SSIs), this study finds.

A total of 34,042 inpatient surgical procedures performed at the University of Alabama at Birmingham Hospital were analyzed during three periods between January 2017 and October 2018—no surgical jackets or bouffant head covers mandated (8 months), surgical jackets mandated (6 months), both surgical jackets and bouffant head covers mandated (8 months).


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During the three periods, there were no significant differences in:

  • SSIs (1.01% vs 0.99% vs 0.83%)
  • mortality (1.83% vs 2.05% vs 1.92%)
  • postoperative sepsis (6.60% vs 6.24% vs 6.54%)
  • wound dehiscence (1.07% vs 0.84% vs 1.06%).

Hospital ordering receipts for the first 6 months of the 2018/2019 fiscal year provided an estimated expenditure of more than $300,000 spent annually on surgical jackets. The bouffant hair covers were less expensive than surgical skull caps ($0.04 per unit vs $0.07).

The results add to the growing body of research that there is no clear benefit to bouffant head covers and long-sleeved surgical jackets in the quest to decrease SSIs. Institutions should evaluate their own data to determine whether recommendations by outside governing organizations are beneficial and cost-effective, the researchers say.

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