AORN has revised its guideline for surgical attire, which will be up for public comment on AORN’s website in January. We invite all perioperative team members (AORN members and nonmembers) and other stakeholders to register on our site and provide their comments.
AORN will continue to recommend that personnel who enter the semi-restricted and restricted areas of the OR cover their hair, scalp and facial hair as hair and skin can harbor bacteria that may be dispersed into the perioperative environment. The evidence suggests that hair is a reservoir for bacteria.
What is new is that we now recommend that an interdisciplinary team at facilities determine the type of head and facial hair coverings that may be worn at the health care organization and if ears should be covered. Perioperative team members should select the type of hair covering based on patient’s risk of developing an SSI and the team member’s risk of exposure to blood, body fluids, and other potentially infectious materials. As traditional head coverings are not considered PPE, if there is a risk that the head will be exposed to blood, body fluids or other potentially infectious materials, a material that is impervious to those substances should be worn.
The evidence does not demonstrate any association between the type of surgical head covering material or extent of hair coverage and the outcome of SSI rates; and the evidence does suggest that ears are a potential reservoir for pathogens, although research has not demonstrated any association between covering the ears and the outcome of SSI rates.
Cloth materials may be worn but should be laundered in a healthcare-accredited laundry facility after each daily use and when contaminated.
AORN has made many changes to the guideline based on a new systematic literature search. A medical librarian with a perioperative background conducted a systematic search of the databases Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, and the Cochrane Database of Systematic Reviews. The search was limited to literature published in English from 2014 through 2018. We based our guideline revision on the new evidence that we found in the search.
