The Core Principles Behind Surgical Attire Rules
For many patients, the rules about what you can't wear to surgery can seem overly strict or even inconvenient. However, every single one of these guidelines is in place for a crucial reason related to patient safety, infection control, and the proper functioning of medical equipment. Understanding the reasoning behind these rules can help ease any anxiety and reinforce the importance of compliance.
Electrical Safety
During many surgical procedures, a device called an electrocautery unit is used to cut tissue and control bleeding by applying a high-frequency electrical current. Any metal on or in a patient's body, such as jewelry or piercings, can conduct this electrical current. This creates a risk of electrical burns to the patient's skin at the point of contact. By removing all metallic objects, healthcare providers eliminate this potential pathway and ensure the electrical current is safely directed away from the body.
Infection Control
The operating room is a sterile environment where preventing infection is the top priority. Personal items like jewelry, makeup, and artificial nails can harbor bacteria and other microorganisms, which increases the risk of contaminating the sterile field and causing a post-operative infection. By asking patients to remove these items and to arrive free of cosmetics, hospitals take a necessary step to protect against contamination and keep the surgical site clean.
Accurate Patient Monitoring
Surgical teams constantly monitor a patient's vital signs during an operation. A key piece of equipment is the pulse oximeter, a small clip placed on a finger to measure oxygen saturation in the blood. For this device to work properly, it needs to be able to read the light transmitted through the natural skin and nail bed. Nail polish, gel nails, or acrylic nails can block this light, resulting in inaccurate or impossible readings. The skin and nail beds can also reveal changes in circulation, and without nail polish, staff can visually check for signs of poor circulation.
Interference with Medical Procedures
Certain personal items can physically interfere with the surgical procedure itself. For example, a tongue piercing can get in the way of placing a breathing tube (intubation) if general anesthesia is used. In other cases, items like contact lenses or dentures can be dislodged or cause injury when the patient is unconscious. Removing these items ensures that medical staff have clear access to all necessary areas and can proceed without obstruction.
The Definitive List: What to Leave at Home
To prepare for surgery, patients should follow a strict pre-operative checklist. The night before and the morning of your procedure are the final opportunities to ensure everything that needs to be removed is taken care of. This includes:
- Jewelry of any kind: This includes rings (including wedding rings), earrings, necklaces, bracelets, and watches. All body piercings—including those in the ears, nose, lip, navel, or genitals—must be removed. If a piece of jewelry cannot be removed, such as a ring that is stuck due to swelling, notify your care team well in advance. They may be able to tape it, but removal is always the preferred option for safety.
- Nail polish and artificial nails: This prohibition applies to all forms of nail adornment, including regular and gel nail polish, dip powder, acrylic nails, and any decals. Medical professionals need to be able to see the natural nail bed to properly monitor your circulation throughout the procedure.
- Makeup and cosmetics: All makeup, including foundation, lipstick, and mascara, must be removed. These products can harbor bacteria, and makeup particles could cause eye irritation while you are unconscious. Some cosmetics also contain ingredients that can be flammable when combined with surgical equipment.
- Hair products and accessories: Avoid using hairspray, gel, or mousse on the day of your surgery. Hair extensions, wigs, and hairpieces must also be removed. Some of these items contain flammable materials or can interfere with proper positioning during surgery.
- Contact lenses: Even if your vision is poor, contacts must be removed. Your eyes will be lubricated and may be taped shut during surgery, and contacts could cause corneal abrasions or other injuries. Wear your glasses and bring a case for them instead.
- Prosthetics and dental work: Dentures, partials, and retainers must be taken out. Staff will provide a denture cup for storage. Similarly, hearing aids may need to be removed, so you should discuss this with your care team ahead of time and bring a case for them.
- Valuables: Leave all credit cards, cash, and electronic devices like phones, tablets, and smartwatches at home or in a secure place. Hospitals are not responsible for lost or stolen items. The fewer items you bring, the less you have to worry about.
- Lotion, powder, or deodorant: Avoid applying any of these products on the day of surgery, as they can interfere with skin prep or medical adhesives used during the procedure.
A Quick Guide: Allowed vs. Prohibited
| Allowed to Wear/Bring | Prohibited |
|---|---|
| Loose, comfortable clothing (e.g., zip-up sweatshirts, sweatpants) | Jewelry of any kind (rings, necklaces, earrings, etc.) |
| Slip-on shoes | Nail polish, acrylic, or gel nails |
| Prescription glasses (bring a case for surgery) | All makeup, including mascara and lipstick |
| Denture case | Hair products (hairspray, gel, mousse) |
| Hearing aid case | Wigs and hair extensions |
| Necessary medical devices (e.g., CPAP machine, inhaler) | Contact lenses |
| Simple hair tie with no metal | Body piercings |
| Pad or tampon (if on period) | Lotion, deodorant, perfumes |
Conclusion: Your Role in a Safe Surgery
By understanding and following the pre-operative instructions, including the list of what not to wear during surgery, you are playing an active and vital role in your own health and safety. These rules are not arbitrary but are carefully crafted protocols to minimize risks and provide the best possible outcome. Following these guidelines ensures that your surgical team can monitor your health accurately and efficiently, and that the sterile environment is maintained to prevent infection. Taking the time to properly prepare can lead to a less stressful and more successful experience. For additional patient information, visit the UChicago Medicine's patient preparation guide.
