To the Editor In their article, “Association of Disposable Perioperative Jackets with Surgical Site Infections in a Large Multicenter Health Care Organization,”1 Stapleton et al performed a retrospective analysis and found no significant difference in the incidence of surgical site infection (SSI) after clean procedures, 26 months before and 26 months after implementation of a policy that required wearing disposable, long-sleeved jackets in all surgical areas at a 12-hospital health care organization. The results are not surprising. Comprehensive infection control policies implemented since the late 1800s have greatly reduced bacteria in the surgical field and dramatically reduced SSIs.2 Farach et al3 estimated a sample size of almost 500 000 would be required to demonstrate a 10% reduction in SSI, almost 10 times the sample size in the Stapleton et al study.1 The cost of the new policy was enormous: more than $1.7 million for more than 2 million disposable jackets.
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Thiel CL, Sherman JD, Hopf HW. Use of Disposable Perioperative Jackets and Surgical Site Infections. JAMA Surg. Published online March 04, 2020. doi:10.1001/jamasurg.2019.6374
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