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Dear All
I agree with Michael’s rationale and agree there are cases of occupational transmission of serious bloodborne illness from mucousal splashes reported in the literature. So from an OCH&S obligation the HCW should comply.
This is one of those frustrating issues that come up from time to time and they drive me crazy. They are like the ? of eating in theatres/ anaesthetists wearing masks/ OT staff changing attire etc. Why IC professionals continually have to fight these causes is exhausting and sad but back to the science….whilst Michael provides a meta-analysis it is a few years old and it is based on very few reports probably because the issue hasn’t been well studied not that the issue isn’t important.
I would also draw attention to the increasing use of air-purifying systems in the US and other countries. Some of the data related to validation studies are very compelling and show how CFU counts of bacteria rise (sometimes to extremes) when speaking (behind masks) happens. Obviously showing causation between high counts/ speaking and actual wound infection is difficult given to the many confounders (# of people in the room/ traffic/ movement/ +/- measures like laminar flow/ skin prep etc etc) but surely it just makes sense for people in the OR to wear masks for everyone’s sake.
Off track..but I recall being asked this exact question by a group of anaesthetists at a scientific meeting in the late 1990s and after responding seriously and scientifically I then added “mask wearing depends on how good looking you are and in your case I would”…as you can imagine it went down like a lead balloon but it silenced the question asker.
I seriously wish you good luck in fighting these battles and I wish the people we served relaised the very serious and very real issues we fight daily and perhaps then they would stop creating distractions like this.
With respect
Cath
Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia
E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au
Hi Fran
This topic has received a fair bit of attention over the years, and yes, your doctors are correct: there is no compelling evidence to suggest surgical face masks reduce surgical site infection rates. See this meta-analysis conclusion: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0064347/
Having said that, my own rationale for staff wearing surgical face masks during procedures is for protection of their mucous membranes from splashing of potentially infectious material. In my view, the ‘strike resistance’ for surgical face masks is of high importance, and has little to do with preventing contamination of the surgical wound.
To suggest staff in a room during a procedure don’t wear masks would in my opinion be asking for trouble. From a occupational health and safety perspective, I would always recommend everyone in a room during a surgical procedure should be wearing a surgical face mask, and eye protection as well.
In my view, anyway.
Cheers
Michael
Michael Wishart
Infection Control Coordinator
A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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Afternoon All,
I require some assistance please.
We’ve had interesting discussions amongst some of Visiting Medical Officers regarding the effectiveness of wearing surgical masks in the operating room to decrease the likelihood of postoperative surgical site infections. The practice of wearing masks is believed to minimize the transmission of oro-and nasopharyngeal bacteria from Theatre Operating staff to patient’s wounds. However a couple of individuals believe there is not enough evidence to support this and therefore don’t think it is necessary to wear surgical masks while operating.
I’m aware of the requirements as per the ACORN Standards and the National Infection Control Guidelines (2016 Draft version), which our Staff complies by, however I cannot find current best practice or evidence to provide to those two individuals.
Any suggestions please? And if you’re willing to share, what is the Policy in regards this matter at your facilities?
Kind Regards
Franciska Ferreira
Infection Prevention & Control/Wound Management Consultant
Burnside War Memorial Hospital
120 Kensington Road, Toorak Gardens, SA 5056
t: 08 8202 7231 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au
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