Does wearing jackets over scrub suits prevent infections?

I always enjoy papers that reinforce my biases. Here’s one called “The Impact of Perioperative Warm-up Jackets on Surgical Site Infection: Cost without Benefit?”

If you’re a regular reader of my blog, you undoubtedly know the answer. Wearing jackets over scrub suits doesn’t prevent infections and adds costs.

Investigators from the University of Minnesota looked at infection rates one year before the institution of a mandatory warm-up jacket over scrub suit policy and one year after.

The rate of surgical site infection for the 13,302 cases done in the year before jackets had to be worn was 2.42% compared to 2.67% for the 12,998 cases done during the year after. The difference was not statistically significant with a p value of 0.1998.

Cell Phones, Germs and Nonsense

Scientific American reports a study from Turkey published in the American Journal of Infection Control found that about 1/3 of cell phones carried by patients and 20% cell phones carried by hospital staff were harboring pathogenic bacteria. Conspicuously absent from the report is any evidence that bacteria found on cell phones actually caused any illness among the patients.

This goes along with other such hysterical reports demonstrating that neckties, lab coats, scrub suits, money, computer keyboards and television remote controls have been found to be similarly colonized with bacteria without evidence of transmission of disease. Of course, lack of evidence of disease transmission did not stop some legislators in New York from considering a proposal to prohibit doctors from wearing ties.

I have no doubt that old-fashioned land-line hospital telephones are colonized with bacteria too.

Having been the prisoner of a telephone for over 40 years in the practice of surgery, I would welcome a ban on its use. Maybe we could use smoke signals but that would probably generate protests by Native Americans and environmentalists.

What many people apparently do not understand is that there is a difference between colonization by bacteria and invasion by bacteria. I suppose I risk causing nationwide panic by saying this but YOUR SKIN IS COLONIZED BY PATHOGENIC BACTERIA!!!!!! AND SO IS YOUR INTESTINE!

I look forward to future papers documenting bacterial colonization of doorknobs, pens, eyeglasses, air, water and fire.

Scrub Suits in Public: Yes or No?

Medical personnel shouldn’t wear scrub suits in public because of the risk of spreading infection. That is the opinion of a retired anesthesiologist named David A. Martin, whose comments were featured in a recent post by William Heisel, a noted health care reporter.

Dr. Martin was particularly concerned about scrub-clad staff patronizing restaurants. He backed up his feelings by asking two such individuals to leave a restaurant, which, surprisingly, they did. His actions were based on the theory that scrub suits are contaminated with hospital-acquired bacteria which could be transmitted to the general public.

While there are numerous reports that scrubs and lab coats worn by medical staff are in fact colonized by pathogens, there are no published papers linking bacteria on scrub suits, lab coats, neckties or cell phones to documented transmission of disease. [See bibliography below.]

So how should we medical people react to Dr. Martin’s position?

In an era where nearly every day a new report emerges that medical errors are killing more patients than the bubonic plague, we need to be aware of our highly visible profile. In the words of the noted philosopher, Andre Agassi, “Image is everything.” Although I doubt very much that anyone is harmed by a nurse or doctor wearing a scrub suit in a restaurant, it just does not look good. Scrubs should also not be worn on a bus or on a trip to the mall.

I would hope that the guys who work in sewage treatment feel the same way about their attire.

Bibliography
Scrub suits & lab coats
Scrub suits & lab coats
Scrub suits & lab coats
Scrub suits & lab coats
Scrub suits & lab coats
Cell phones
Ties