Does Having a Beard Matter? An Analysis of Orthopaedic Surgical Site Infection Rates in Outpatient Orthopaedic Surgery

Abstract

Objectives Post-operative infections cause significant morbidity and mortality in outpatient orthopaedic surgery. Orthopaedic surgical site infections have been estimated to occur in up to 5.6% of patients. Prior research has evaluated infection prevention related to operating room attire and hygiene, but no study has evaluated the effect on postoperative infection rates from surgeons having a beard. Methods Two fellowship-trained orthopaedic surgeons operated on a total of 940 patients during a consecutive 12-month period. During the first six months, surgeons were clean-shaven, and in the last six months, surgeons maintained a beard. A standard mask was worn at all times. Infectious complication data were collected retrospectively. Major infection was defined as hospitalization and/or return to the operating room, and minor infection was classified using the Centers for Disease Control and Prevention (CDC) Surveillance Criteria for surgical site infections (SSI). Results Three (0.31%) patients developed a major infection, and 57 (6.05%) patients developed a minor infection. Of 471 patients operated on when surgeons were clean-shaven, two (0.42%) and 30 (6.62%) developed a major or minor infection, respectively. Of the 469 patients operated on when surgeons had beards, one (0.21%) and 27 (5.75%) patients developed a major or minor infection. The difference in major (P=1.00) and minor (P=0.80) infection rates between the 6-month periods was insignificant. Conclusions Similar infection rates for outpatient surgery were found when the surgeons did and did not have a beard. These findings indicate that while wearing a standard surgical mask, a surgeon having a beard at the time of surgery does not affect the postoperative infection rate.