The Evidence: Dermatologists Are Already Questioning PPE Orthodoxy

We've received evidence that specialty surgery is ready for change. Gardner and colleagues (2026) surveyed dermatologists and Mohs surgeons across the globe, uncovering practices that challenge conventional PPE wisdom.

The numbers tell a remarkable story. For diagnostic biopsies, 40% of dermatologists operate in normal work clothes rather than sterile scrubs. Among Mohs surgeons — specialists performing some of the most precise cancer surgery — three-quarters wear only clean scrubs during tumour extirpation. One in five uses clean rather than sterile gloves.

These aren't rogue practitioners ignoring safety protocols. These are evidence-led clinicians who understand that lower-resource approaches can maintain low surgical site infection rates whilst reducing environmental impact.

The Uncomfortable Truth About Single-Use PPE

Here's what the survey reveals: despite enormous variation in PPE practices, patient outcomes remain consistently excellent. This suggests we've been over-engineering our approach to surgical attire for decades.

The research found disposable caps and masks still predominate across dermatologic surgery. Yet there's limited evidence these single-use items offer superior protection compared to reusable alternatives. We're burning through resources — and budgets — based on habit rather than science.

Consider the environmental mathematics: every disposable surgical cap generates approximately 15g of waste per use. Multiply that across thousands of procedures, and we're looking at tonnes of unnecessary polypropylene ending up in landfills. The survey authors conclude that evidence-based standardisation could maintain excellent outcomes whilst improving sustainability.

Why This Matters for Every Operating Theatre

Dermatologic surgery operates under unique pressures. Many procedures happen in office-based settings rather than hospital operating theatres. There's constant scrutiny on cost-effectiveness. Patient volumes are high, and margins are often tight.

These conditions have created natural laboratories for sustainable practice. When dermatologists demonstrate that clean gloves work well for certain procedures, they're providing evidence that applies across surgery. When they show that reusable attire maintains safety standards, they're validating approaches the rest of healthcare can adopt.

The implications extend far beyond dermatology. If specialty surgeons performing thousands of procedures annually can maintain excellent outcomes with reduced PPE intensity, what does that mean for orthopaedics, general surgery, or cardiac procedures?

The survey reveals an opportunity for healthcare leaders to follow dermatology's evidence-based approach. We can reduce costs, slash environmental impact, and maintain the safety standards patients deserve. The question isn't whether we can afford to make this transition — it's whether we can afford not to.

Sources

• Gardner, G., Macdonald, I., Wernham, A., & Hunt, W. (2026). An International Survey Characterising Surgical Attire and Personal Protective Equipment (PPE) in Dermatologic and Mohs Surgery. The Australasian Journal of Dermatology. DOI: 10.1111/ajd.70042

Medicus Caps has been supporting this transition toward sustainable surgical attire since our founding. Our reusable surgical caps offer the evidence-based solution that forward-thinking departments are seeking — combining superior comfort, professional appearance, and reduced environmental impact.

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