Kudos to Erik Stapleton et al for assessing the association of disposable perioperative jackets with surgical site infections. The study was performed in a large multi-center health care organization. This paper was recently published in JAMA Surgery. An untested hypothesis tested.The AORN recommends mandatory adoption of disposable perioperative jackets for surgical site infection reduction. This trial with multi-variable analysis concluded that disposable perioperative jackets are not associated with surgical site infections in clean operative procedures. The finding is not surprising as most surgical site infections originate from the patient's own endogenous flora and not external factors.
Mandating an intervention based on little to no evidence is fraught with peril and subject to provider backlash.This is precisely why our policy of bare below the elbows (BBE) is an infection prevention recommendation and not a mandate. BBE is simple, safe, and cheap, unlike the wasteful and expensive disposable perioperative jackets. Over time, BBE transformed into normative behavior at VCU health, as published here.
As for mandatory disposable perioperative jackets, it may be time for a strategy reconsideration.
