Comparative efficacy assessment of different surgical caps in the operating room

Background: Infectious agents have a strong correlation with peri-operative and post-operative complications1. Previous studies suggest that operating room staff sheds a large number of bacteria normally associated with skin particles into the air2. In the current study we attempted to analyze the efficacy of 4 different surgical caps that are most commonly used in the operating rooms today. The primary objective of this study was to determine the type of surgical cap that would most effectively contain bacteria contamination and prevent dispersion. Secondary object was to assess overall effectiveness of the surgical caps in containing and preventing dispersion of bacteria. Methods: A mannequin head with wig was used to imitate the head of a healthcare professional. Talc was dispersed evenly on the wig to mimic bioburden of the head and neck region. The head was subsequently covered with four different surgical caps and repositioned to facilitate talc spread. Photos of the dispersed talc under the black light and fluorescent light were taken after each observation. The amount of the talc dispersion was analyzed using histogram in Adobe Photoshop 7.0™. Results: All digital photos were subsequently modified with Adobe Photoshop 7.0™ to narrow the frequency range to the upper band beyond the bulk of the image data in order to enhance perception of the talc dispersion. By adjusting visual frequency range to the darker limit of the spectrum we were able to improve visibility of the white color in the images. After narrowing the spectrum range we used histogram function to mathematically analyze the amount of the talc dispersion on the black paper. Conclusions: It has been concluded from this modeling study that bouffant reusable type of the surgical cap is the most effective in terms of the prevention of potential microbial contamination of the surgical field from the skin area of the head by the caregiver’s debris. Skull design of the surgical caps showed very similar results in terms of effectiveness in both reusable and disposable designs. From our experiment we concluded that bouffant reusable design of the surgical cap reduced the efficacy of the bacterial and epidermal bioburden spread. Further studies in the operating room using microbiological techniques are much needed.

George W. Williams, Denys Goloshchapov, Rabail Chaudhry and Luis Z. Ostrosky
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