Do Anaesthetists Need to Wear Surgical Masks in the Operating Theatre? A Literature Review with Evidence-Based Recommendations

Abstract

Many operating theatre staff believe that the surgical face mask protects the healthcare worker from potentially hazardous biological infections. A questionnaire-based survey, undertaken by Leyland 1 in 1993 to assess attitudes to the use of masks, showed that 20% of surgeons discarded surgical masks for endoscopic work. Less than 50% did not wear the mask as recommended by the Medical Research Council. Equal numbers of surgeons wore the mask in the belief they were protecting themselves and the patient, with 20% of these admitting that tradition was the only reason for wearing them. Policies relating to the wearing of surgical masks by operating theatre staff are varied. This indicates some confusion about the role of the surgical mask in modern surgical and anaesthetic practice. This review was undertaken to collate current evidence and make recommendations based on this evidence.

The use of surgical facemasks during cataract surgery: is it necessary?

“…The necessity for routine use of surgical facemasks during interventional procedures has been questioned. [2][3][4] The majority of the clinical research carried out to date on the topic concern general surgical and gynaecological procedures.…”

“…Since then there have been numerous studies attempting to determine whether the use of face masks has a significant effect on reducing surgical wound infection. [2][3][4][5][6][7][8][9][10] Unfortunately the evidence in the literature has often been conflicting with little definitive guidance offered.…”

The Importance and Implications of Aseptic Techniques During Regional Anesthesia

“…Despite these limited case series and anecdotal case reports, definitive evidence that wearing a face mask causes fewer postoperative wound infections is still lacking. 67 However, it does appear that face masks may be critically important in protecting patients from clinicians with sore throats, 68 those suffering from recurrent tonsillitis, 23,64 or those who are chronic nasal carriers of S aureus. 69 …”

Respiratory and facial protection: a critical review of recent literature

“…splashing or spraying of blood, and to protect others from the wearer as a source of infection. 15,16 It has also been recommended that a surgical face mask with attached face shield or a surgical facemask and goggles should be used for the protection of the wearer during aerosol-generating procedures in patients who are not suspected of being infected with an agent for which respiratory protection is otherwise recommended. 2 The use of surgical masks as part of the Transmission Based Precautions (TBPs) is designed to protect healthcare workers from exposure to potentially infective respiratory droplets.…”