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Could wearing scrubs outside the hospital prove dangerous to patients? The rapid and scary increase in antibiotic-resistant bacterial infections all around the world may be in part due to contamination of medical uniforms.

Surgical scrubs are comfy. They are casual. They are a favorite attire of doctors, nurses, and surgical technicians both inside and outside the operating room.

There's no doubt that scrubs pick up bacteria. What is in question is whether those bacteria can then "jump" to another patient. Most hospitals have policies that require that surgical scrubs actually worn during surgery must be laundered after use, before wearers go into other parts of the facility. However, most hospitals and clinics do not have policies prohibiting the wearing of scrubs that have not been worn in the OR anywhere in the hospital and even in restaurants, in private cars, on buses, and at home.

One expert on the transmission of bacterial infections by surgical attire, Dr Julia Sammons, medical director of the department of infection prevention and control at the Children's Hospital of Philadelphia, told reporters for an online publication called Newsworks that there simply is not enough scientific evidence that scrubs worn outside the hospital can pass on infections. "Until robust evidence exists, or more robust clinical studies are done, our focus is more on evidence-based practices, including hand hygiene, the isolation of patients with communicable diseases, and disinfecting of the environment. These things have strong evidence behind them for reducing the press of germs in hospitals."

Common sense, it is often noted, is not necessarily common. The very idea of washing hands before and after surgery, for example, was vigorously resisted by doctors when an Austrian surgeon named Ignaz Semmelweiss introduced it in 1847. Chances are that, if you live near a medical center, you will encounter many off-duty doctors, nurses, and lab and surgical technicians running around hospital scrubs, and there's not a lot you can do about it.

However, there are other aspects of infection control that are already backed up by science that your hospital is likely to be using to protect you.

New fabrics for surgical gowns kill viruses and bacteria before they can be transmitted.

Sometimes you will look up from the operating table in the OR and you'll see doctors and nurses dressed in what looks like raincoats. New, non-woven fabrics, consulting of multiple layers of plastics (usually a plastic outer layer, a plastic film middle layer, and a polyester inner layer) can actually trap microorganisms as small as HIV and as large as many kinds of parasites and bacteria. These uniforms protect medical personnel as well as subsequent patients.

New materials for gloves reduce the risk that a doctor will transmit germs from his or her hand to the patient.

Doctors and nurses and surgical technicians "scrub in" before surgery, carefully washing their hands and nails to make them free of bacteria. Inevitably, however, they miss a few microbes that can begin to grow and multiply in just minutes. Surgical gloves are often nicked, stretched, or cut, giving these bacteria a chance to escape and infect the patient.

New antimicrobial materials used to make surgical gloves kill bacteria even while the surgeon is performing the operation. This way, even if the gloves are damaged, infection is less likely to occur.
Continue reading after recommendations

  • Scott M. Should scrubs be worn only inside hospitals to limit the spread of germs? Newsworks. January 15, 2015. http://www.newsworks.org/index.php/local/the-pulse/77247-should-scrubs-be-worn-inside-hospitals-only-to-limit-the-spread-of-germs Accessed 8 April 2015.
  • Zayas G, Chiang MC, Wong E, MacDonald F, Lange CF, Senthilselvan A, King M. Effectiveness of cough etiquette maneuvers in disrupting the chain of transmission of infectious respiratory diseases. BMC Public Health. 2013 Sep 8. 13:811. doi: 10.1186/1471-2458-13-811.PMID: 24010919.
  • Photo courtesy of Walt Stoneburner via Flickr: www.flickr.com/photos/waltstoneburner/3373057519
  • Photo courtesy of Army Medicine via Flickr: www.flickr.com/photos/armymedicine/7093478345

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