The effectiveness and compliance of surgical face mask wearing in the operating suite environment: An integrated review

Problem identification: Surgical face masks have been used for over a century in the operating room (OR); firstly, as it has been believed that they may reduce surgical site infections (SSIs) in patients and, secondly, as personal protective equipment (PPE) for staff. However, recent studies have reported disparities in the efficacy of wearing surgical face masks including inconsistency in their use. This integrative review aims to investigate the effects of surgical masks in the OR, in regard to maintaining both patient and staff safety, and will discuss compliance or lack thereof in face mask usage for the entire multidisciplinary team. Literature search: Four electronic health databases were used to identify the relevant research: CINAHL, Medline, EMCare and Cochrane Library. The reference lists of retrieved articles were also manually searched and appropriate literature retrieved. Data evaluation synthesis: Inclusion and exclusion criteria were used revealing that 15 articles fully met the criteria which were critiqued (see Table 2 in Supplemental material for the literature matrix). Implications for practice: SSIs are multifactorial and no reviewed studies looked at causative considerations such as comorbidities and other variables (such as hypothermia) which could all contribute to this post-operative complication. However, there is evidence to suggest that surgical face masks are useful in decreasing the biological load in the theatre environment. They are also a vital piece of PPE that should be worn to protect the perioperative team from blood and bodily fluid splatter that commonly occur.