Unnecessary
Underwear Removal For Surgeries
A
number of surgery centers and hospitals across the United States,
as well as in other countries, have routine policies requiring
that patients to remove underwear for all surgeries even if
they do not involve the groin area or genitals. This ritual
has been practiced for umpteen years. Originally, it was an
Operating Room tradition seemingly without clear medical indication
Fortunately,
as of 2018, some hospitals have changed these policies and now
allow patients to wear 100% cotton underwear during many surgeries.
One hospital’s example of this type of policy allowing
underwear: Only 100% cotton underwear is permitted.
No Nylon underwear will be allowed.
The routine
removal of patients’ underwear was first introduced when
nylon underwear could potentially cause static electricity.
Brown (1993) describes the ritual of making patients
coming to the operating theatre remove their underwear as the
“most illogical of rituals”. It is still
practiced in many surgical units and should be stopped for the
good reason that it causes embarrassment to the patient and
serves no useful purpose. It has been traditional for patients
to put on clean clothing (and in some units to remove underwear)
on the ward before being taken to the operating theatre. Any
risk of infection from airborne spread from socially clean clothing
is unlikely to be large because, in comparison with the operating
team, little patient movement occurs during operations thus
reducing the dispersal of microorganisms from skin and clothing.
How
To Respond To Arguments By Medical Professionals:
1.) We may need to insert a urinary catheter
– Urinary Catheter is rarely needed for most surgeries
that only take only a few hours. See article about unnecessary
urinary catheters.
2.) Underwear could become stained by prep and body
fluids – Most patients do not care about this
and would prefer to have their underwear stained than sacrifice
modesty.
3.) Underwear could have metals in them –
Most underwear does not have metals in them. Patients could
simply wear 100% cotton underwear with no metals or disposable
underwear.
4.) Need for antiseptic cleaning of the groin
– This is not relevant unless the groin is in the operative
field. Patients routinely cleanse their entire body with a sterile-type
solution 2-3 times before surgery.
5.) We need immediate emergency access to femoral vessels
in case of emergencies – Underwear can be removed
quickly if necessary. There is a minimal percentage of this
happening.
6.) No underwear helps to maintain a sterile environment
– The operating room is not as sterile as the medical
profession claims. If the ‘no underwear’ policy
helped to maintain a sterile environment, doctors and nurses
should not wear underwear either. Medical professionals often
carry more germs than the surgery patient because of restroom
breaks as well as interactions with numerous other patients
all without changing scrubs in between. Most infections that
happen as a result of surgeries are due to medical professionals
not washing their hands and bringing germs into the operating
room.
Look at
this statement from Behaviour
and Rituals in the Operating Theatre – Orthoteers:
A recent editorial from Canada noted no increase in
infection rates in patients undergoing day-case cataract removal
when the patients remained fully dressed to enter the theatre,
including their ordinary shoes.
It is very
disturbing that operating room personnel at some hospitals routinely
remove patients’ gowns and underwear once the patient
is under anesthesia and re-dress the patient before he or she
wakes up. This is very unethical and deceptive. Many patients
have no idea how they are completely exposed when they are under
anesthesia.
We have received stories of some very heartbreaking cases. One
lady who had hand surgery woke up naked before they were able
to put the gown back on. There was no reason for her to be naked.
She could have easily worn underwear, shorts, and bra with no
metals for this kind of surgery. It would have been best if
she could have opted for local or regional anesthesia and not
general anesthesia.
A knee surgery patient’s genitals will often be exposed
if he/she is not wearing underwear when the surgical team lifts
her/his gown. Patients should be allowed to wear 100 percent
cotton underwear or disposable underwear for all surgeries that
do not involve genitals such as lobectomy, knee replacement
surgery, etc.
Patients
that have to undergo hip surgery, cardiac catheterizations in
the groin, cardiac bypass surgery, and other surgeries that
require access to the groin are encouraged to check out the
dignity garments invented by an orthopedic surgeon at Covr
Medical that cover their genitals.
All patients should write on their consent form that they do
not allow removal of underwear for surgeries which do not involve
the genitals; and request a copy of the consent form with the
surgeon’s signature. Patients need to stand up and break
this ridiculous operating room tradition which violates patients’
modesty.
Check out
this podcast, No
Underwear For Surgery. A woman who had foot surgery
was forced to remove her underwear unnecessarily.
If your hospital still has a policy that requires you to remove
your underwear for all surgeries, you should consider starting
a petition at your hospital to end this outdated policy. You
can use this sample
petition and modify it.
Sources:
Behaviour
and Rituals in the Operating Theatre - Orthoteers
Page
51 under Patient’s Clothing in Advancing Perioperative
Practice
Surgical
Site Infection: Prevention and Treatment of Surgical Site Infection
Surgery
and Your Modesty
What
Should You Know Before You Have Surgery
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