What is the appropriate "dress code" for the cardiac catheterization laboratory?

Area of Science:

• Cardiology
• Infectious Disease Prevention
• Healthcare Epidemiology

Background:

• Cardiac catheterization is a common procedure with a risk of infection.
• The impact of personnel attire on infection rates in cardiac catheterization labs is debated.

Purpose of the Study:

• To investigate the relationship between the manner of dress of personnel and observers and cardiac catheterization-related infections.
• To identify factors influencing infection incidence in cardiac catheterization procedures.

Main Methods:

• A retrospective survey of 107,203 cardiac catheterization procedures (55,976 cutdowns, 53,578 percutaneous).
• Analysis of infection rates based on attire protocols (mask, cap, gown) and laboratory procedure volume.
• Comparison of infection incidence between percutaneous and cutdown techniques.

Main Results:

• Overall infection incidence was 0.35% (379/109,554 sites).
• Percutaneous procedures had a low infection rate (0.06%), unaffected by attire.
• Cutdown procedures showed a lower infection rate (0.48%) when full sanitary clothing was mandated compared to when not (0.72%).
• Laboratories with higher cutdown volumes (>150/year) had significantly fewer infections than lower-volume labs (<150/year).

Conclusions:

• Cardiac catheterization infection risk is more strongly correlated with laboratory procedure volume than with the manner of dress.
• Wearing full sanitary clothing (mask, cap, gown) can help decrease infection rates specifically for cutdown procedures.
• Optimizing lab workflow and volume may be more critical for overall infection control than strict attire mandates for all personnel.