title: Use of face masks by non-scrubbed operating room staff: a randomized controlled trial.
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).
  
  
  CONCLUSIONS
  Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. joan_webster@health.qld.gov.au
authors.forename: Joan
authors.initials: J
authors.lastname: Webster
authors.forename: Sarah
authors.initials: S
authors.lastname: Croger
authors.forename: Carolyn
authors.initials: C
authors.lastname: Lister
authors.forename: Michelle
authors.initials: M
authors.lastname: Doidge
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Terry
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
mesh_terms: D000328:Adult; D001315:Australia; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008397:Masks; D008875:Middle Aged; D009873:Operating Rooms / Q000592:standards; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D000078329:Workforce