Patient Footwear Contamination in Ophthalmic Day Surgery: A Prospective Observational Study

Abstract

Introduction : Surgical site infections (SSIs) remain significant healthcare challenges. This study investigates the cleanliness of patient footwear in an ophthalmic day surgery setting. Methods : An observational study was conducted over a period of 8 weeks. A total of 94 patients were included. Shoe cleanliness was graded according to an in-house standardized system. Other data included shoe type, contamination, weather conditions, and demographics. Logistic regression analyses were used to identify trends. Results : Poor shoe hygiene (contamination) was more common in males (OR = 2.89, 95% CI: 1.18 - 7.09) and surprisingly during sunny weather conditions (OR = 1.31, 95% CI: 0.57 - 3.03). Smart shoes were the most frequently worn type (n = 19), primarily by females in sunny conditions, while sneakers were more common among males in rainy conditions. No complications/infections were identified during follow-up. Conclusions : This study highlights an area of infection control that has received relatively little attention. The study demonstrates that shoes entering an operating environment are not infrequently soiled particularly in poor weather and in men. It is suggested that simple interventions such as overshoes or disposable slippers could enhance cleanliness and potentially improve patient safety with relatively little cost.