Facial Hair and Infection: A Beardly Question with a Bald Spot in the Literature

Authors

Kyle O'Connor, HCA HealthcareFollow
Samuel Stegelmann, HCA HealthcareFollow
Hans Drawbert, HCA HealthcareFollow
Edwin Dudoussat, HCA HealthcareFollow
John T. RiehlFollow

Files

Division

North Texas

Hospital

Medical City Denton

Specialty

Orthopedic Surgery

Document Type

Poster

Publication Date

2025

Keywords

facial hair, infection, surgical site infections

Disciplines

Medicine and Health Sciences | Orthopedics | Pathological Conditions, Signs and Symptoms | Surgery | Surgical Procedures, Operative

Abstract

Background: Upholding a sterile environment in orthopedic surgery is vital to minimize surgical site infections (SSIs). Among personal protective equipment, beard covers for surgical staff with facial hair have been recommended as a measure to prevent contamination. However, their effectiveness in reducing SSIs remains uncertain, especially in orthopedic procedures that often involve high-risk implants and extended exposure of surgical fields. This systematic review assesses the current evidence on the role of beard covers in infection prevention during surgery. Methods: Using PRISMA guidelines, databases were searched for studies investigating facial hair, beard covers, and infection risk. Eligible studies included comparative studies, laboratory experiments, and consensus statements. Quality was assessed using MINORS and CASP tools, while certainty of evidence was graded using GRADE criteria. Results: 617 studies were extracted from databases and eight met inclusion criteria. Clinical studies did not demonstrate a statistically significant difference in SSI rates between uncovered bearded surgeons, uncovered clean-shaven surgeons, or with the use of beard covers. Laboratory studies provided mixed results on bacterial shedding associated with facial hair. A consensus statement highlighted insufficient evidence to recommend beard covers as standard practice. Conclusions: The current evidence is equivocal when determining the role for beard covers for SSI reduction in orthopedic surgery. Given the lack of evidence-based data, further high-quality research is needed to justify the routine use of beard covers in infection prevention and operating room protocols.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

O'Connor, Kyle; Stegelmann, Samuel; Drawbert, Hans; Dudoussat, Edwin; and Riehl, John T., "Facial Hair and Infection: A Beardly Question with a Bald Spot in the Literature" (2025). North Texas Research Forum 2025. 66.
https://scholarlycommons.hcahealthcare.com/northtexas2025/66