The specialized clothing worn by surgeons and their teams is mandatory attire designed to maintain a highly controlled environment within the operating room. This attire serves the primary function of infection control, significantly reducing the risk of transferring microorganisms to the patient during a procedure. Every piece of the ensemble promotes patient safety by limiting microbial contamination and is a foundational element of aseptic technique for all personnel entering the surgical suite.
The Foundation of Attire
The initial layer of clothing worn by all surgical personnel is known as “scrubs,” a simple two-piece shirt and pant uniform. Scrubs are non-sterile apparel provided and laundered by the hospital facility to ensure strict hygiene standards and prevent tracking contaminants from outside. Surgical teams often wear scrubs in blue or green because these hues reduce eye fatigue during long operations. These colors also minimize the visual impact of blood stains. This attire establishes a barrier between staff street clothes and the semi-restricted areas of the operating suite.
The Sterile Protective Layer
Surgeons and team members working directly at the surgical site don a second, specialized layer to maintain the “sterile field,” an area free of microorganisms. This layer includes a sterile surgical gown and gloves, donned after a thorough surgical hand scrub in a process called “gowning and gloving.” Gowns are constructed from fluid-resistant or impermeable materials to prevent the penetration of blood and bodily fluids. This material acts as a barrier, separating microbial sources on the surgeon’s skin and scrubs from the patient’s exposed tissues.
The entire gown is not considered sterile; only specific zones are designated to guide the surgical team’s movements. The sterile area is limited to the front of the gown, extending from the chest down to the level of the sterile operating table. The sleeves are considered sterile only from two inches above the elbow down to the cuff. The neckline, shoulders, underarms, and the entire back of the gown are unsterile and must not contact sterile instruments or the surgical site. The cuffs are also unsterile because they absorb moisture and must be completely covered by the sterile gloves.
Head, Face, and Foot Coverings
Specific coverings for the head, face, and feet complete the surgical ensemble, functioning as source control to prevent microbial shedding. A surgical cap or hood is mandatory for all personnel entering the operating suite to cover all hair, including facial hair. Since hair and the scalp are sources of organisms and particulate matter, the cap prevents the shedding of hair and dandruff into the environment.
A surgical mask is worn over the nose and mouth to filter droplets expelled during breathing or speaking, which may contain microorganisms. Masks primarily protect the patient from the surgical team but also protect the wearer from potential fluid splashes. Eyewear or a full face shield is often worn over the mask to protect the surgeon’s eyes from blood or other bodily fluids that may splatter. Shoe covers are placed over the staff’s shoes to prevent the tracking of contaminants into the operating room and protect the wearer from fluids on the floor.