Use of face masks by non‐scrubbed operating room staff: a randomized controlled trial

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Abstract
Background: Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections (SSIs) when non‐scrubbed operating room staff did not wear surgical face masks. Methods: Eight hundred twenty‐seven participants undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital were enrolled. Complete follow‐up data were available for 811 patients (98.1%). Operating room lists were randomly allocated to a ‘Mask group’ (all non‐scrubbed staff wore a mask) or ‘No Mask group’ (none of the non‐scrubbed staff wore masks). The primary end point, SSI was identified using in‐patient surveillance; post discharge follow‐up and chart reviews. The patient was followed for up to six weeks. Results: Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre‐operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89). Conclusion: Surgical site infection rates did not increase when non‐scrubbed operating room personnel did not wear a face mask.