A recent study by researchers at Bon Secours Tuckahoe Orthopedics of Richmond, Va., examined whether the personal cloth scrub caps that some surgeons like to wear in the OR could put patients at greater risk of surgical site infections.
The study, published in the journal Patient Safety in Surgery, examined the issue as a growing number of hospitals now require disposable paper scrub caps in their ORs. The question basically boiled down to whether such requirements are necessary to prevent patient infection risk. “Current literature has not identified a significant difference in the infection risk between cloth and disposable scrub caps,” the authors noted.
The team thus sought to measure the difference in bacterial colonization between cloth and paper scrub caps. “It was predicted that personal cloth scrub caps would have a higher infectious load than disposable caps,” they wrote. That prediction turned out to be accurate.
The prospective cohort study took place at a non-profit, 391-bed medical center. Researchers sampled 58 cloth and 49 paper scrubs caps from 107 medical personnel within the sterile field, including surgeons, physician assistants, nurse practitioners, surgical assistants, and scrub nurses … all of whom wore their preferred cap style and material.
Swab collections were cultured for three days on blood agar plates, evaluated for bacterial colony growth and quantified on a scale of zero for no bacterial growth to four for full or nearly full colonization. The reusable cloth scrub caps were found to have more colony forming units and higher growth ranks than the paper caps.
“Attention should be given to the proper sterilization of cloth scrub caps in order to decrease the infectious load on items in the operating room,” the researchers wrote. They concluded that reusable cloth scrub caps “carried a greater bacterial load, both in colony quantity and size, than disposable paper scrub caps, and thus have a greater potential for surgical site infection when laundering status is not controlled.”
Further studies should be conducted to assess surgical site infection rates of disposable scrub caps compared to reusable scrub caps “without selecting for freshly laundered status,” they wrote.
Read the full study here.
