Davis Philip J, Spady Donald, Forgie Sarah E D
Department of Pediatrics and Stollery Children's Hospital, Edmonton, Alberta, Canada.
Am J Infect Control. 2007 Sep;35(7):455-9. doi: 10.1016/j.ajic.2006.08.011.
There is little evidence that surgical mask use by physicians in the operating room (OR) reduces surgical site infections (SSIs), but masks do protect the wearer from potentially infectious splashes. Face shields offer even more protection because they cover the eyes, but they may be perceived as offering less protection to the patient than do masks. The objectives of this study were to ascertain if there were predictors to determine which OR physicians are continuing to use masks and what their reasons are for doing so, and which OR physicians would accept face shields and their reasons for doing so.
We surveyed the province of Alberta's surgeons, general practice (GP) surgeons, anesthesiologists, and GP anesthetists to determine how many physicians in the OR wear surgical masks, their reasons for wearing surgical masks (ethical, legal, protection of the patient, protection of the wearer), and if they believe that face shields offer more protection to the patient or to the wearer. We also sought to examine which demographic factors affected their responses. The data were examined with chi(2) analysis to assess the relationships of age and practitioner type, and for various outcome variables. A significance level of P < .05 was accepted as statistically significant.
The sex of the physician did not affect his/her responses. Older physicians believe that the OR team has an ethical and legal responsibility to wear surgical masks; masks are worn to prevent the spread of disease, not because it is tradition to do so; masks protect the wearer more than do face shields; and wearing face shields alone will subject the patient to higher rates of SSIs. Surgeons are more likely than are anesthesiologists to wear surgical masks in the OR and wear a surgical mask and a face shield if the patient has risk factors for a blood borne infection.
According to our survey, age and profession were the most important variables that affected the potential use of surgical masks and face shields. Younger OR physicians likely would be amenable to using face shields in addition to masks in the OR to protect themselves from exposure to blood or bodily fluids.
几乎没有证据表明手术室(OR)中的医生使用外科口罩能降低手术部位感染(SSIs),但口罩确实能保护佩戴者免受潜在感染性飞沫的侵害。面罩提供的保护更多,因为它们能遮住眼睛,但人们可能认为面罩对患者的保护不如口罩。本研究的目的是确定是否存在预测因素,以确定哪些手术室医生继续使用口罩以及他们这样做的原因,哪些手术室医生会接受面罩以及他们这样做的原因。
我们对艾伯塔省的外科医生、普通外科(GP)医生、麻醉师和普通麻醉师进行了调查,以确定手术室中有多少医生佩戴外科口罩,他们佩戴外科口罩的原因(伦理、法律、保护患者、保护佩戴者),以及他们是否认为面罩对患者或佩戴者提供了更多保护。我们还试图研究哪些人口统计学因素影响了他们的回答。使用卡方分析来检验数据,以评估年龄与从业者类型之间的关系以及各种结果变量。P < 0.05的显著性水平被认为具有统计学意义。
医生的性别不影响其回答。年长的医生认为手术室团队有伦理和法律责任佩戴外科口罩;佩戴口罩是为了防止疾病传播,而不是因为这是传统做法;口罩对佩戴者的保护比面罩更多;仅佩戴面罩会使患者面临更高的手术部位感染率。在手术室中,外科医生比麻醉师更有可能佩戴外科口罩,如果患者有血源性感染的风险因素,则会佩戴外科口罩和面罩。
根据我们的调查,年龄和职业是影响外科口罩和面罩潜在使用的最重要变量。年轻的手术室医生可能愿意在手术室中除了佩戴口罩外还使用面罩,以保护自己免受血液或体液暴露的影响。