title: The effect of gowning on labor epidural catheter colonization rate: a randomized controlled trial.
abstract: BACKGROUND
  The need to gown for labor epidural catheter insertion is controversial. The American Society of Regional Anesthesia and Pain Medicine has identified a lack of randomized controlled trials investigating this issue. The purpose of this study was to examine the effect of gowning on colonization rates following epidural catheter insertion for labor analgesia.
  
  
  METHODS
  Following research ethics board approval and informed written consent, parturients were randomized to undergo epidural analgesia with the anesthesiologist either ungowned or wearing a sterile gown. Cultures were obtained from each of the operator forearms, the work area under the insertion site, and from the epidural catheter tip as well as from the catheter segment adjacent to the insertion site. The primary outcome was growth of any microbial organisms from the cultured sites.
  
  
  RESULTS
  Two hundred fourteen patients completed the study. There were no significant differences in catheter-tip colonization rates between the ungowned and gowned groups (9.2% vs 7.6%, respectively). The most common microorganism that was cultured was coagulase-negative Staphylococcus.
  
  
  CONCLUSIONS
  The use of gowns in the current study did not affect catheter colonization rate. Overall, there was a relatively high incidence of catheter-tip colonization in both groups, which underscores the need for strict aseptic technique.
authors.affiliation: From the *Department of Anesthesia and Pain Management, Mount Sinai Hospital; †University of Toronto; ‡Department of Microbiology, Mount Sinai Hospital; and §Departments of Laboratory Medicine and Pathobiology and Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Naveed T
authors.initials: NT
authors.lastname: Siddiqui
authors.forename: Sharon
authors.initials: S
authors.lastname: Davies
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
authors.forename: Jose C A
authors.initials: JC
authors.lastname: Carvalho
authors.forename: Zeev
authors.initials: Z
authors.lastname: Friedman
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects / Q000295:instrumentation*; D001207:Asepsis; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D005260:Female; D005542:Forearm; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D048949:Labor Pain / Q000175:diagnosis / Q000188:drug therapy*; D009864:Ontario; D010820:Physicians; D011247:Pregnancy; D012307:Risk Factors; D012867:Skin / Q000382:microbiology*; D058257:Surgical Attire; D016896:Treatment Outcome