American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

American College of Surgeons Issues Statement on Appropriate Professional Attire for Surgeons

New guideline, based on evidence, reaffirms what an official attire policy should be


CHICAGO (August 8, 2016): The American College of Surgeons (ACS) has released a statement on professional attire for surgeons in and out of the operating room (OR). The new ACS guideline for appropriate attire is based on professionalism, common sense, decorum, and the available evidence.  It reaffirms what an official attire policy should be and includes the following tenets:

  • Soiled scrubs and/or hats should be changed as soon as feasible and certainly before speaking with family members after an operation.
  • Scrubs and hats worn during dirty or contaminated cases should be changed prior to subsequent cases even if not visibly soiled.
  • Masks should not be worn dangling at any time.
  • Operating room scrubs should not be worn in the hospital facility outside of the OR area without a clean lab coat or appropriate cover up.
  • OR scrubs should not be worn at any time outside of the hospital perimeter.
  • OR scrubs should be changed at least daily.
  • During invasive procedures, the mouth, nose, and hair (skull and face) should be covered to avoid potential wound contamination. Large sideburns and ponytails should be covered or contained. There is no evidence that leaving ears, a limited amount of hair on the nape of the neck or a modest sideburn uncovered contributes to wound infections.
  • Earrings and jewelry worn on the head or neck where they might fall into or contaminate the sterile field should all be removed or appropriately covered during procedures.
  • The ACS encourages surgeons to wear clean, appropriate professional attire (not scrubs) during all patient encounters outside of the OR.

In addition, the statement provides details on wearing the skullcap in a way that ensures patient safety, and puts forth respective cleaning or disposal recommendations for cloth and paper caps. To facilitate enforcement of the guideline on wearing scrubs only within the perimeter of the hospital, the ACS also suggests the adoption of distinctive, colored scrub suits for OR personnel.

“This statement reflects our strong commitment to surgical patient safety. It’s important to provide an optimal surgical care environment for our patients. These recommendations for a comprehensive dress policy for surgeons will help us to achieve that goal,” said ACS Executive Director David B. Hoyt, MD, FACS.

The College is collaborating with the Centers for Medicare & Medicaid Services and the Joint Commission to ensure that their policies and regulatory oversight activities are aligned with these ACS recommendations.

The statement was approved by the ACS Board of Regents in July, and will be published in the October Bulletin of the American College of Surgeons.

To view the entire statement online, visit:

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 80,000 members and is the largest organization of surgeons in the world. For more information, visit


Sally Garneski 
Dan Hamilton