OR Attire: Does it Impact Quality?

Operating room attire has changed substantially since the use of dedicated surgical coats in the nineteenth century with the expanded acceptance of germ theory. Current practices in many developed countries involve predominantly the use of disposable attire that covers most of the body, hair, and face. Modern operating room attire serves a dual purpose of protecting patients from surgical site infections which are the most common, costly, and morbid hospital-acquired infection while also protecting those working in the operating room from transmissible diseases. Several iterations of guidelines have been published by various surgical, anesthesia, surgical technologists, and nursing bodies. Historically, these guidelines were based on lower-quality evidence due to the relative paucity of high-quality studies; however, there was a surge in research studies after unilateral implementation of low-quality evidence-based guidelines in the mid-2010s. More recent evidence suggests that there is little basis for the implementation of fully disposable operating room attire over reusable or any specific use of any one type of surgical headwear over another. Current operating room attire practices should be created using the best available evidence and involve input from all of the different personnel who work together in the operating room while also evaluating interventions in the context of their economic and environmental impact.