# Does the evidence support the use of operating room shoe covers to prevent surgical site infections? A scoping review

## TL;DR

This review finds no strong evidence that shoe covers in operating rooms prevent surgical infections and highlights their environmental impact.

## Contribution

The study provides a comprehensive scoping review on the effectiveness and environmental impact of OR shoe covers.

## Key findings

- Evidence is mixed on whether shoe covers reduce bacterial contamination in operating rooms.
- Only one study linked reduced use of disposable PPE, including shoe covers, to fewer surgical site infections.
- No study showed a direct reduction in surgical site infections from using shoe covers alone.

## Abstract

To determine whether operating room (OR) shoe covers prevent surgical site infections (SSIs) and to assess their environmental and clinical impact.

Scoping review.

Hospital operating room environments in international healthcare systems.

We searched Emcare, Embase, MEDLINE, and SCOPUS for studies examining shoe covers and outcomes related to bacterial contamination or SSIs. Data were synthesized descriptively.

Six studies met inclusion criteria. Evidence was mixed regarding bacterial contamination: some showed fewer colony forming units with shoe covers, while others found no effect or even higher contamination. Only one study assessed clinical outcomes, reporting fewer SSIs following reduced use of disposable PPE (including shoe covers). No study demonstrated a direct SSI reduction from shoe covers alone.

Evidence does not support OR shoe covers in preventing SSIs. Their use adds environmental burden through single-use plastics. More rigorous studies are needed to confirm these findings and guide sustainable infection prevention practices.