Biljan M M, Hart C A, Sunderland D, Manasse P R, Kingsland C R
Department of Obstetrics and Gynaecology, University of Liverpool.
BMJ. 1993;307(6919):1582-4. doi: 10.1136/bmj.307.6919.1582.
To assess level of contamination of neckwear worn by gynaecologists and obstetricians during routine working week.
Multicentre randomised double blind crossover trial. Participants wore the same conventional ties for three days in one week and bow ties for the same period in second week.
Two teaching and three district general hospitals in the midlands, Wales, and north England.
15 registrars and senior registrars.
A swab soaked in sterile saline was taken from specific area on ties at end of first and third working days and sent in transport medium for culture on chocolatised blood and MacConkey agar for 48 hours.
Level of bacteriological growth assessed semiquantitatively (0 for no contamination; for heavy contamination) after swabs had been cultured. At end of study the participants completed a questionnaire to assess their attitude toward wearing different types of necktie.
12 doctors (80%) completed the study. Although bow ties were significantly less contaminated at end of first working day (z = -2.354, p = 0.019), this difference was not maintained; there was no difference in level of contamination on third day. Level of contamination did not increase between first and third day of wearing the same garment. One of the 10 doctors who returned the questionnaire found the bow tie very uncomfortable. All participants would consider wearing a bow tie if it proved to be less contaminated than a conventional tie.
Although a significant difference in contamination was established between conventional and bow ties on first day of study, this difference was not confirmed on third day and there is unlikely to be any real association between tie type and bacterial contamination. Because of its negative image and difficulty to tie, the bow tie will probably remain a minority fashion.
评估妇产科医生在常规工作周佩戴的领带的污染程度。
多中心随机双盲交叉试验。参与者在一周内的三天佩戴相同的传统领带，在第二周的同一时期佩戴领结。
位于中部地区、威尔士和英格兰北部的两家教学医院和三家地区综合医院。
15名住院医师和高级住院医师。
在第一个和第三个工作日结束时，从领带上的特定区域采集浸有无菌生理盐水的拭子，并在运输培养基中送检，在巧克力血琼脂和麦康凯琼脂上培养48小时。
拭子培养后，半定量评估细菌生长水平（无污染为0；重度污染为 ）。在研究结束时，参与者完成一份问卷，以评估他们对佩戴不同类型领带的态度。
12名医生（80%）完成了研究。虽然在第一个工作日结束时，领结的污染程度明显较低（z = -2.354，p = 0.019），但这种差异并未持续；第三天的污染水平没有差异。在佩戴同一条领带的第一天和第三天之间，污染水平没有增加。在返回问卷的10名医生中，有1人觉得领结非常不舒服。如果事实证明领结比传统领带污染少，所有参与者都会考虑佩戴领结。
虽然在研究的第一天，传统领带和领结之间的污染存在显著差异，但在第三天并未得到证实，领带类型与细菌污染之间不太可能存在任何实际关联。由于领结形象不佳且难以系上，它可能仍将是少数人的时尚选择。
