Title: Bouffant vs Skull Cap and Impact on Surgical Site Infection
Authors: Shanu N Kothari, Madeline J Anderson, Andrew J Borgert, Kara J Kallies, Todd J Kowalski
Published in: Journal of the American College of Surgeons, August 2018
Background: The study addresses a debate in the medical community regarding the effectiveness of bouffant caps versus skull caps in reducing surgical site infections (SSIs). The American College of Surgeons deems skull caps acceptable, while the Association of Perioperative Registered Nurses recommends bouffant caps, despite the lack of scientific evidence favouring either in SSI reduction.
Study Design: The research analysed data from a previous prospective randomised trial focusing on the impact of hair clipping on SSIs. Patients were categorised based on the attending surgeons' preference for either bouffant or skull caps.
- The study included 1,543 patients.
- Surgeons used bouffant caps in 39% of cases and skull caps in 61%.
- SSIs occurred in 8% of cases with bouffant caps and 5% with skull caps, a difference statistically significant in the initial comparison.
- However, after adjusting for the type of surgical procedure, no significant differences in SSI rates were observed between the two cap types.
Conclusions: The preference of the attending surgeon for either bouffant or skull caps does not significantly impact SSI rates when surgical procedure type is taken into account. The study suggests that future guidelines should consider these findings, and that surgeon preference should guide the choice of operating room headwear.