A prospective service evaluation of sterile gloves alone versus sterile gloves and gowns in elective skin surgery.

Personal protective equipment (PPE) protects the patient from contamination of the surgical site and operating team from potential infection arising from the blood and body fluids of the patient. National guidelines in England recommend that operative teams wear sterile gloves and gowns during surgery. However, PPE is known to be associated with increased cost and carbon footprint. The aim of this study was to determine whether omitting sterile gowns during skin surgery affected surgical site infection (SSI), cost and carbon footprint. A prospective service evaluation was performed at the Frimley Health NHS Foundation Trust from 01/07/2024 to 08/09/2024. All patients who underwent elective skin surgery under local anaesthetic were included. Routinely collected data were gathered from the electronic health record. A total of 378 patients were included. The sterile gloves and gown (GG) group included 279 surgical sites in 179 patients. The sterile gloves only (GO) group included 251 surgical sites in 199 patients. A similar SSI rate (GG 3.9%, GO 4.0%) and potential cost saving of approximately £1920 and carbon reduction of 393 kgCO2e was observed in the GO group when compared to the GG group. This study raises the question on whether sterile gowns are necessary for certain surgical procedures. Omitting sterile gowns can result in substantial cost and carbon savings when extrapolated across national activity. A randomised controlled trial is needed to support evidence-based decisions on surgical PPE.