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What Do Surgeons Wear on Their Heads?

Operating rooms must be completely sterile. A minor infection can be fatal in an environment where different people are cut up and opened.

Patients trust surgeons with their lives; an accident is morally reprehensible.

Also, hospitals want to live up to the highest safety standards. Otherwise, they will lose their reputation and certifications.

Because of this, surgeons and operating room personnel wear uniforms that protect them and the patients they treat. One of these is their headwear.

What do surgeons wear on their heads? You’ll find out here.

Kinds of surgical caps

When we think about surgeons (especially in pop culture), we imagine them wearing scrubs and surgical caps. Surgeons wear two types of caps: skullcaps and bouffant caps.

Skullcaps

For many decades, skullcaps have been the standard hair covering for surgeons. Like many headwears, skullcaps are close-fitted, covering the areas of hair under them. Elastic bands and ties also make these caps more adjustable for surgeons.

Many of these caps are green or blue, but ones with designs and patterns are available in the market. These styles can help patients feel more comfortable and make the surgeons look friendlier.

Although these are worn by millions worldwide, wearing skullcaps brought controversies about surgical safety (more on this later). Nonetheless, wearing skullcaps is still a norm in the majority of hospitals and operating rooms.

Bouffant caps

Wearing bouffant caps is currently recommended by surgical boards and associations since they seem safer and more effective. They completely conceal the surgeons’ hair, even the ones on the nape of their neck.

Furthermore, these caps are polypropylene, a plastic fabric that serves as a protection against particulate matter but remains breathable and lightweight for the hair. In comparison, many fabric skullcaps can bring discomfort to the wearer.

These caps thoroughly prevent hair from falling into the patients. Bouffant caps also limit the risk of contamination and exposure to harmful liquids, fine dust, and microbes both for the surgeon and the patient.

Bouffant caps are credible and disposable that these are used in other industries as well, like factories,  restaurants, and packaging sites.

Why hair needs to be covered?

The head is one of the warmest portions of our bodies. Because of this, it can facilitate viruses and bacteria that cause diseases. Surgeons’ hair can also be a home for dust, dirt, and hospital matter.

Dandruff quickly shed off and float in the air, potentially bringing contaminants with it.

Inside sensitive environments like hospitals and operating rooms, there must be no risk of infection. Surgical caps effectively cover the hair and all the undesirable matter that might be lurking there.

How surgical caps help?

To further understand how surgical headwear (skullcaps and bouffant caps) contribute to the safety and sterility of operating rooms, here are the classification of surgical wounds that surgeons handle:

  1. Clean surgical wounds are not infected nor inflamed, and the operation does not enter tracts where bacteria may live (such as the respiratory, genitourinary, and gastrointestinal tracts). These wounds are stapled or sewn once the operation concludes.

This kind of surgical wound is made in operating on hernia, the spleen, the thyroid glands, and the breasts.

  1. Clean-contaminated wounds involve the respiratory, gastrointestinal, and genitourinary tracts within a controlled setting to avoid contamination.

This wound comes in surgical operations that remove the gallbladder and treat the lungs, colon, and bowels.

  1. Contaminated wounds deal with accidental incisions that have exposure to unsterile environments. It involves spillage in the gastrointestinal organs and inflammations with no pus yet.
  1. Dirty wounds include severe cuts with dead flesh, abscess, perforation, and infections. In these cases, microorganisms are already present in the area that must be repaired and treated through surgery.

All of these kinds of surgical wounds are sensitive to one factor: bacterial count. Therefore, even a speck of hair or dandruff must not fall into the operation room. What surgeons wear on their heads can be life-saving, indeed!

History of surgical caps

The use of these protective caps evolved with the field of surgery through the centuries. Before the science of medicine had been formalized, nuns and monks ran infirmaries supported by their religion.

In these facilities, they wore their religious headwear. In effect, they unconsciously protected their patients from their hair and dandruff.

In the 1800s, Florence Nightingale established what would become modern nursing. She used hats as a part of nursing uniforms awarded to the graduates of her London nursing home. These hats also indicated the wearer’s rank.

In 1914, doctors, surgeons, and medical personnel started using caps as a part of their uniforms. By the 1940s, using surgical caps became a requirement in hospitals and operating rooms.

From that point on, surgeons and their colleagues used caps with different designs and styles.

Controversy

In the last decade, the use of skullcaps and bouffant caps has been a contested issue among hospital administrators, surgeons, and nurses.

The two most respected organizations for operating room nurses and surgeons — the Association of periOperative Registered Nurses and the American College of Surgeons, respectively — released contradictory yet strictly mandated standards on surgical caps. 

The Association of periOperative Registered Nurses argues that skullcaps have a weakness: they leave some sideburns and back hair exposed. It declared that it poses a risk of infection.

Because of this mandate, many hospitals banned surgical skullcaps in favor of bouffant caps.

On the other hand, the American College of Surgeons maintains that skullcaps symbolize the surgical field, so the medical industry must not discard them.

Instead, they recommend washing and changing cloth skull caps every day, while users should regularly throw away disposable caps.

Despite these debates and the ban on skullcaps in many hospitals, both aisles of the issue have no decisive evidence on which kind of surgical caps is better.

Surgeons are likewise divided in this issue since they have various preferences on what they want to place on their heads. Some find the bouffant caps annoying because it is loose, but others find using cloth skullcaps disgusting.

However, the bottom line is that surgeons must follow the hospital’s standards on surgical caps.

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