Surgical Attire Study Published Cloth Caps Demonstrated to Be More Effective than Bouffant Caps - American Society of Anesthesiologists (ASA)

FDA & Washington Alerts

Surgical Attire Study Published: Cloth Caps Demonstrated to Be More Effective than Bouffant Caps

On October 26, 2017, the Journal of the American College of Surgeons published a study assessing the difference among cloth hats, disposable skull caps and disposable bouffant hats. The study, titled “Hats Off: A Study of Different Operating Room Headgear Assessed by Environmental Quality Indicators,” concluded:

“No significant differences were observed between disposable bouffant and disposable skull caps with regard to particle or actively sampled microbial contamination. However, when compared with disposable skull caps, disposable bouffant hats did have significantly higher microbial shed at the sterile field, as measured by passive settle plate analysis.”

Surgical Attire has been a significant concern for physician anesthesiologists and the American Society of Anesthesiologists (ASA). Physician anesthesiologists have often been frustrated as a common goal of attire policies has been infection prevention. ASA has asked that the Centers for Medicare & Medicaid Services as well as accreditation organizations that facilities should use outcomes- and evidence-based guidelines when assessing local implementation of attire and infection control policies.

The ASA Public Relations Department is working with Immediate Past President Jeffrey Plagenhoef, M.D., FASA on a podcast to describe this study and the efforts of ASA to meet local physician anesthesiologist needs regarding infection control and surgical attire. The ASA House of Delegates at its October 2017 meeting approved an ASA Statement on Developing Policy for Infection Prevention Related to Surgical Attire.

The study was funded by the American College of Surgeons and the American Society of Anesthesiologists.

For more information, please contact ASA Department of Quality and Regulatory Affairs at

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