ACS Updates Guidelines on Operatory Attire



In dentistry, “dress for success” is more than sartorial advice. Noting that clean and properly worn clothing can decrease the incidence of healthcare-associated infections, the American College of Surgeons (ACS) has updated its guidelines for appropriate attire in the operatory.

For example, soiled scrubs and hats should be changed as soon as feasible and before speaking to family members after surgical procedures. Also, scrubs and hats worn during dirty or contaminated cases should be changed prior to subsequent cases even if they aren’t visibly soiled.

Furthermore, operating room (OR) scrubs should not be worn in outside of the OR area without a clean lab coat or appropriate cover-up over them. They should not be worn at any time outside of the hospital perimeter either. And, OR scrubs should be changed at least daily.

During invasive procedures, the mouth, nose, and hair should be covered to avoid potential wound contamination. Large sideburns and ponytails should be covered or contained. However, there is no evidence that leaving ears, a limited amount of hair on the nape of the neck, or a modest sideburn uncovered contributes to wound infections.

Similarly, skullcaps can be worn when it covers nearly all of the practitioner’s hair and only a limited amount of hair on the nape of the neck or a modest sideburn remains uncovered. Cloth skullcaps also should be cleaned and changed daily, while paper skullcaps should be disposed after every dirty or contaminated case. Religious beliefs about headwear should be respected without compromising patient safety.

Masks should not be worn dangling at any time. Earrings and jewelry worn on the head or neck where they might fall into or contaminate the sterile field all should be removed or appropriately covered during procedures. And finally, clean and appropriate professional attire—not scrubs—should be worn during all patient encounters outside the OR.

Noting that appropriate attire helps establish and maintain a rapport between physicians and patients based on trust and respect, the ACS believes that attention to detail in attire will help uphold the public perception of physicians as highly trustworthy, attentive, professional, and compassionate.

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