Patient Clothing

A measure neglected in most guidelines

Is patient clothing a remarkable aspect in SSI prevention

Is it a matter of course for you that patients do not wear their personal clothing in the operating room, but rather special surgical clothing,e.g. a surgical shirt?

While other aspects of preparing the patient for surgery, such as showering, hair removal and skin disinfection, are mentioned in all guidelines, the wearing of specific clothing for the patient is not addressed in most cases.

Only NICE explicitly includes this measure in its recommendations.1


GuidelineRecommendationCategory (if mentioned)

“Give patients specific theatre wear that is appropriate for the procedure and clinical setting, and that provides easy access to the operative site and areas for placing devices, such as intravenous cannulas. Take into account the patient's comfort and dignity.”



Denise Leistenschneider, Senior Clinical Consultant
“If medical staff have to wear special clothing in the operating theatre to protect against the transmission of germs, it seems only logical that the patient should also wear special area clothing.”

Recommended instruction

Patient theatre wear
Patients should wear specialized surgical attire1

  • appropriate to the procedure and clinical setting1

  • that allows unobstructed access to the surgical site and areas where devices need to be placed, such as intravenous cannulas1

  • that takes into account the comfort and dignity of the patient1

Joint guidelines of the Healthcare Infection Society and the European Society of Clinical Microbiology and Infectious Diseases5

Statement in this context

“Patients entering an operating theatre are often required to remove their clothing and wear a freshly laundered surgical gown, but this may also be unnecessary and potentially uncomfortable, especially when a person is asked to remove more intimate garments. Little evidence is available regarding whether the practice of changing into theatre attire helps to reduce SSI. In previous guidelines, no recommendation was made as to patients wearing their personal clothes in the theatre, but these guidelines acknowledge that it may not always be necessary for patients to remove all their clothing.”5

Click to see full list References
  1. NICE (2020) Surgical site infections: prevention and treatment. NICE guidelines. Published: 11 April 2019. Last updated:19 August 2020.
  2. CDC (1999) Guideline for Prevention of Surgical Site Infection. Infect Control Hosp Epidemiol. 20(4): 247–278.
  3. WHO (2018) Global guidelines for the prevention of surgical site infection. World Health Organization 2018.
  4. KRINKO (2018) Prävention postoperativer Wundinfektionen. Empfehlungen der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Bundesgesundheitsbl 61: 448–473.
  5. Humphreys H, et al. (2023) Rituals and behaviours in the operating theatre e joint guidelines of the Healthcare Infection Society and the European Society of Clinical Microbiology and Infectious Diseases. J Hosp Infect 140: 165.e1–165.e28.

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