Reusable scrub caps are not just a preference. Three separate bodies of research — on infection control, on team communication, and on carbon — point the same way. This page collects the studies we rely on, with citations, so you can check them yourself.
Infection control
The largest meta-analysis to date pooled nine studies covering 45,708 surgical cases and found no significant difference in surgical site infection rates between reusable and disposable headwear (OR 0.79; 95% CI 0.59–1.07). Gumera et al., Journal of Hospital Infection, 2024.
Markel et al. (Journal of the American College of Surgeons, 2017) found that cloth skull caps shed fewer particles and microbes than disposable bouffants. The CDC/HICPAC evidence-based guideline for SSI prevention does not specify disposable headwear, and the 2018 American College of Surgeons joint statement notes that "the commonly used disposable bouffant is the least effective for particle containment".
Team communication and patient safety
Communication failures occur in roughly 30% of operating theatre exchanges, and around 90% of those failures negatively affect the case (Lingard et al., 2004). A Stanford study published in JAMA Network Open in 2023 found that caps carrying a name and role increased the odds of a colleague being called by name 13-fold, with 80% of participants reporting improved teamwork (Wong et al., n ≈ 1,000). A 2025 systematic review in Health Science Reports found labelled caps reduced misidentification errors by 65–78% across the included studies (Giordano et al.).
Carbon and waste
A meta-analysis by Keil et al. (2023) found a 61% mean carbon reduction when theatres switch from disposable to reusable headwear, alongside a 93% reduction in solid waste. A Plymouth NHS Trust pilot put the carbon break-even point at 16–19 uses. Dal Mas et al. (2024) estimate each reusable cap replaces 200–250 disposables a year, preventing around 2.5kg of plastic waste per staff member.
Operating theatres account for 4–5% of total healthcare carbon emissions, and single-use items contribute 68% of surgical carbon emissions. The NHS net zero target for direct emissions is 2040.
Working out your own numbers
If you are building a business case, our hospital savings calculator and reusable vs disposable impact calculator let you put your own figures in. You can also read our sustainability promise and see how NHS trusts have made the switch.