Surgical face masks

[Walter Petorski]

I have never worn a surgical face mask in theatre. A few times I work with a new surgeon who asks me to put one on, and I refuse politely, and ask him to show me the evidence that they do any good. I have never been presented with this evidence.

Do others have any strong feelings on this issue.

I should point out that recently two of our surgeons have taken to not wearing face masks, although one had glasses for his own protection.

[Russell Coupland]

The emphasis of face masks seems to have shifted from protection of the patient (by preventing wound infection), for which there is little evidence, to protection of medical personel from mucosal contact with patients' fluids. It makes sense, then, to wear a face mask if you are at risk of contamination from blood or other fluids. For anesthesiologists who are usually 1-2 meters away from the surgical field, there is little justification.

[George Miklos]

Never worn a face mask. Surgeons never had the balls to challenge me on it.

[jetproppilot]

How compelling it is, the differences in practice in different countries! I practice in the US and I'd venture to say that there isn't an OR in the country that has personnel without facemasks, with the exception of urology cases. Whether or not its justified or not is not the issue here since alot of things are done for medico-legal purposes.

[Bucky]

I'm curious about this face mask-in-the-theatre thingy.

Is not wearing face masks common in England, too?

Do the circulating nurses in the OR also not wear face masks?

Bucky

[gasman]

Don't know about England, but here in Australia it is common practice for anaesthetic staff to not wear face masks in theatre. Certainly not universal but common. Or at most a token attempt to comply with surgeons wishes - the aneasthetist is the one with a face mask on but hanging well below the nose.

In my hospital also, there are two surgeons who do not wear face masks during surgery, although both wear eye protection.

As I understand it, face masks do not provide any patient protection afterthe first 15 minutes of use (by which time they are saturated with surgeons fomites). In fact there is some evidence to show that by continual rubbing against the face, they promote shedding of skin cells onto the patient and therefore are more harm than good. Of course, they will protect the surgeon from inadvertent blood and fluid splashes from the patient.

Our infectious diseases department has decreed that for most surgery, face masks are to be worn by all theatre personel who are within 2 meters of the surgical site -this excludes the anaesthetist for most cases. They have decreed that anaesthetists should wear masks while intubating (for our own protection, rather than the patient's).

I note jetproppilot's comment about medicolegal reasons to wear masks - its interesting to note that the legal profession does not use evidence-based practice to formulate a case, because then there would be no case to be made for face masks.

[Peter Davies M.D.]

Or is this no-face-mask thing an attempt at defining our superiority or at least professional independence from surgeons?

[alroth]

It's of concern this position to not use face mask in theatre... not by "evidences" but in order to maintain the respectability with our specialty and with us... "Surgeon don't have bolls"... And my country is the "third world"!!!!

[gasboy]

It's common practice to wear masks on orthopaedic theatres in the UK, usually just to keep the peace!
Most other theatres are pretty relaxed about it.
Most general surgeons only wear them for personal protection, if at all.