tag:blogger.com,1999:blog-4968787219619380438.post332699436665808288..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Finally, evidence clarifies the surgical caps controversySkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger23125tag:blogger.com,1999:blog-4968787219619380438.post-25239290182901790982018-11-15T22:04:50.545-05:002018-11-15T22:04:50.545-05:00Anyway,the doctor is fully armed when performing s...Anyway,the doctor is fully armed when performing surgery on the patient. Hats, masks, gloves, disposable surgical gowns are essentialWilliam J. Williamshttps://www.tomtop.com/accessories-10486/noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-37129486941888390842017-06-20T13:57:56.926-04:002017-06-20T13:57:56.926-04:00Codi, welcome to a world where there is no nuance,...Codi, welcome to a world where there is no nuance, no room for extenuating circumstances, and no deviation from a rule because "it's a rule." Never mind that the rule is not based on any evidence. Yes, welcome to the world of modern medicine.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-11642895665969295442017-06-20T13:13:59.374-04:002017-06-20T13:13:59.374-04:00I'm a CST of 15 years and my hospital has now ...I'm a CST of 15 years and my hospital has now mandated we all wear the disposable bouffant hats OVER our cloth hats no matter the type of cloth hat. The reason I went to a bouffant cloth hat was because my 3 foot long hair could no longer be contained in the skull cap comfortably. The disposable bouffant hats not only can not hold my hair but they also break my skin out. I break out from the "hypoallergenic scrubs" we are made to wear so I take some clean ones home to wash and I bring them back in in a sealed bag. Now my issue is I have to cover my cloth scrub hat with a disposable bouffant hat that breaks me out because the "cloth hat might not be clean enough" I wash it with the scrubs I bring in but I don't have to cover the scrubs? Having a CST with boils on her from the disposable bouffant hats is better than pissing off AORN apparently.Anonymoushttps://www.blogger.com/profile/16930680263177055045noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-45898236445227481032017-05-29T19:14:01.497-04:002017-05-29T19:14:01.497-04:00Anon Europe, I shaved my head for years. The rule ...Anon Europe, I shaved my head for years. The rule still was I had to wear a bouffant cap. I got around it though. The story is in one of the posts I linked to. <br /><br />Artiger, I doubt these two studies will change the AORN's position. As you noted, it's also about power and who is in charge. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-74583481108300034532017-05-29T16:37:29.433-04:002017-05-29T16:37:29.433-04:00What little hair I have remaining is kept very sho...What little hair I have remaining is kept very short...a cap has no problem covering it. <br /><br />I'm sure AORN has some counter studies underway to attempt to save face. It's just another attempt at wrestling control. I wish they'd find a better use of their time, and their members' dues. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4354873968369805092017-05-29T13:19:40.450-04:002017-05-29T13:19:40.450-04:00Anonymous Europe: I have been shaving my head bald...Anonymous Europe: I have been shaving my head bald for the past 10 years every day.:) Does not matter what I wear.:D Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-45595317448338360652017-05-28T21:02:36.675-04:002017-05-28T21:02:36.675-04:00One good clip with a St. Mayo scissors solves that...One good clip with a St. Mayo scissors solves that irritating elastic band on the bouffants. You can even obscure the cut elastic with the lower mask tie. My favorite cap was a bouffant with the annoying elastic band excised.Oldfoolrnhttps://www.blogger.com/profile/01747485143127099085noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-64899490096597681612017-05-27T15:50:13.928-04:002017-05-27T15:50:13.928-04:00Yes, no evidence that the bouffant is better.Yes, no evidence that the bouffant is better.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4059559874735023162017-05-26T16:45:56.514-04:002017-05-26T16:45:56.514-04:00Yup. I didn't wear the shower-cap either, unti...Yup. I didn't wear the shower-cap either, until it was mandated. The elastic always annoyed me, and *I* was able to scratch! <br /><br />Agreed - no evidence? Go away, clipboard lady.George Gasmanhttps://www.blogger.com/profile/05047584545571558203noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72431383059144002822017-05-25T21:48:10.721-04:002017-05-25T21:48:10.721-04:00There's no evidence that one cap is better tha...There's no evidence that one cap is better than another so it shouldn't be an issue at all. I think surgeon comfort is important especially in a long case. I hated the way a bouffant cap felt. It was irritating and at times distracting. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72011341234936966482017-05-25T17:46:16.740-04:002017-05-25T17:46:16.740-04:00I don't have the studies at hand, but iirc, on...I don't have the studies at hand, but iirc, one study on the effectiveness of face masks showed that there was indeed a higher incidence of infection - among those not wearing the masks, not the patients! <br /><br />My understanding is that in Great Britain, the only people in the OR wearing masks are those at the table: surgeon, assistant, scrub nurse. No one else is.<br /><br />However, returning to headgear. Other than the issue of comfort (and I for one always found the "cap" more comfortable than any hood or shower-cap) is there any other reason for the objection besides the vanity of the wearer? Before you jump on me, note that I have a full beard, and I *always* wore a cap, until the clipboard carriers killed it.<br /><br />No question that, yeah, it "looks better," but should vanity be the deciding factor it OR attire? <br /><br />If there's no evidence that one's better than the other from a patient standpoint, let them wear whatever they wish. Everyone has a bit of vanity and comfort preferences. All I'm saying is that we should acknowledge that and do as we please, clipboard carriers be damned.George Gasmanhttps://www.blogger.com/profile/05047584545571558203noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-74194113394629334132017-05-25T10:39:21.475-04:002017-05-25T10:39:21.475-04:00I do not believe there is any evidence that wearin...I do not believe there is any evidence that wearing a facemask reduces surgical site infection rates. Having been splashed in the face on many occasions, I think everyone at the table should wear a mask to protect themselves.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-57485685361059761792017-05-25T10:35:21.253-04:002017-05-25T10:35:21.253-04:00There were some in UK a while back who didn't ...There were some in UK a while back who didn't wear face masks; this didn't seem to catch on.<br /><br />Is there any evidence for their use?Korhommehttps://www.blogger.com/profile/02290764661952746389noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13866177045326239372017-05-25T08:44:43.089-04:002017-05-25T08:44:43.089-04:00Artiger, I'll be shocked if the AORN gives up ...Artiger, I'll be shocked if the AORN gives up on this. It's not their style.<br /><br />Old, I remember when the perineal fallout business started. OR nurses used to wear dresses. One day they were banned. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-54495641401045563692017-05-23T21:50:53.455-04:002017-05-23T21:50:53.455-04:00A long time ago the bureaucratic agencies were obs...A long time ago the bureaucratic agencies were obsessed with containing perineal fallout. We were carefully monitored for snug fitting rubber bands on our scrub pant cuffs. I have a post on my blog about this nonsense- oldfoolrn.blogspot.com.<br /><br />I don't which sounds more goofy. In depth studies of surgical cap usage or crotch confinement studiesOldfoolrnhttps://www.blogger.com/profile/01747485143127099085noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-44317899225868818962017-05-23T20:21:38.208-04:002017-05-23T20:21:38.208-04:00I'm really surprised that AORN was willing to ...I'm really surprised that AORN was willing to fall on a sword without some sort of credible evidence. I've known them (via their members) to be a much more reputable organization than what they have displayed. Same could be said about the ACS, with their "symbolism" nonsense. Still, although I don't think this battle is necessarily over, the surgeons certainly struck a serious blow. If AORN has any sense, they'll quietly back away from this one. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-61396280398620340812017-05-23T18:10:11.512-04:002017-05-23T18:10:11.512-04:00I assume the director will not be signing up to re...I assume the director will not be signing up to receive email notifications of my new blog posts. Are you from the U.K. or Ireland? Piss off is what they say over there. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-88753397468961770902017-05-23T17:53:16.207-04:002017-05-23T17:53:16.207-04:00I sent this to the director of the OR at my instit...I sent this to the director of the OR at my institution and was told to piss off. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-62289203158909932972017-05-23T09:06:27.925-04:002017-05-23T09:06:27.925-04:00George, great story. In a few words, it tells you ...George, great story. In a few words, it tells you a lot about what is wrong with bureaucracies. I bet the inspector felt pretty good about catching that mistake too. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-44523832149063244552017-05-23T08:29:55.357-04:002017-05-23T08:29:55.357-04:00The bean-counters and policy-makers don't care...The bean-counters and policy-makers don't care about anything *other* than policy. Patient safety comes second.<br /><br />To wit: We had a "surprise" visit from our state public health department. They dropped in to see how the OR functions, and one inspector was watching a case get set up. During setup, an x-ray tech wheeled her machine into the room, and the back of her unsterile gown brushed against the sterile table. NO ONE SAW THIS OTHER THAN THE INSPECTOR. <br /><br />Guess what happened? We got cited for a break in sterile technique. That's probably legit.<br /><br />Guess what else happened? The case proceeded as though nothing had happened.<br /><br />In other words, a break in technique, seen by the inspector, was enough to cause a citation, but not enough to notify the staff that such a break occurred.<br /><br />Gotta keep that clipboard filled with checkmarks.George Gasmanhttps://www.blogger.com/profile/05047584545571558203noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-51681566657330411242017-05-23T07:09:01.417-04:002017-05-23T07:09:01.417-04:00Yes, George, it's policy.
Korhomme, the pati...Yes, George, it's policy. <br /><br />Korhomme, the patient's skin is a common source of infection, but infections can be caused by unsterile instruments, breaks in sterile technique, technical errors by the surgeon and other factors. What type of cap is worn or how much hair is exposed? Nope.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-28225318518378242242017-05-22T17:17:43.086-04:002017-05-22T17:17:43.086-04:00I thought that most post-op infections were caused...I thought that most post-op infections were caused by the patients' own germs, so that what sort of caps surgeons wore was largely irrelevant. Is this no accepted today?Korhommehttps://www.blogger.com/profile/02290764661952746389noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-60539728723465661302017-05-22T17:00:51.880-04:002017-05-22T17:00:51.880-04:00(I'm *so* glad to be retired...)
But, science...(I'm *so* glad to be retired...)<br /><br />But, science be damned. It's POLICY, dontcha know?George Gasmanhttps://www.blogger.com/profile/05047584545571558203noreply@blogger.com