At present, available scientific evidence does not demonstrate any association between the type of hat and surgical site infection rates. One recent study on head coverings (disposable bouffant , disposable skullcap and cloth cap) identified that the commonly available disposable bouffant hat is the least effective barrier to transmission of particles. (1-5)
Despite limited evidence from studies utilising patient-centred outcomes staff choosing to wear reusable theatre caps should give consideration to how they will launder them. Perhaps a reasonable request would be to change and launder them after every shift or if they become visibly soiled.
We recognise that reusable theatre hats present the most suitable location for clear staff name and role identification given the workflows of operating theatres. We also recognise that clearly visible name and role identification is associated with improved communication, team work and ultimately patient outcomes. (6)
We also recognise the significant environmental benefits of reusable hats over disposable. It has been estimated that a hospital with over 20 theatres would avoid discarding over 100,000 disposable hats every year if they adopted reusable hats universally. Disposable theatre hats are made from ‘viscose’ a substance whose manufacture causes significant environmental detriment. (7)
References:
1. Hussein S. et al. Neurosurgery, Volume 82, Issue 4, 1 April 2018, Pages 548–554.
2. Haskins I.N. et al. Hernia (2017) 21: 495-503.
4. Markel TA et al. Journal of the American College of Surgeons, 225(5): 573-581,2017.