Shoe Covers

[Buckeye(OH)]

When I first started surgery as a third year, I made damn sure to put shoe covers on for fear of being yelled at by the scrub nurses.

As I have progressed, I have noticed fewer and fewer people wearing shoe covers. I suppose this makes sense from the aspect of, if it falls that low, its not sterile anyways.

Perhaps shoe covers were designed to protect the shoes rather than the patient?

Ive been not wearing covers in keeping with whatever everyone else is doing at the places I rotate, but I find this odd as obviously, there are ALWAYS boxes of shoe covers right next to the masks.

Thoughts?

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[SouthernSurgeon]

Yup - shoe covers are for the benefit of your shoes.

 

[SocialistMD]

Perhaps shoe covers were designed to protect the shoes rather than the patient?

Bingo.

 

[Winged Scapula]

Yeah, I never wear those things, although those booties that Ortho wears came in handy during Trauma, Ob-Gyn and some emergent Vascular cases.

Tip for Buckeye(OH): check your shoes, forehead and neck before you go out and talk to family. Blood and pieces of fat on your shoes don't go over well with the fam.

 

[Buckeye(OH)]

Interestingly, there is a pulm attending that wears shoe covers when hes in the OR for a bronch.....BUT NO SHOES!

 

[SLUser11]

When I first started surgery as a third year, I made damn sure to put shoe covers on for fear of being yelled at by the scrub nurses.

As I have progressed, I have noticed fewer and fewer people wearing shoe covers. I suppose this makes sense from the aspect of, if it falls that low, its not sterile anyways.

Perhaps shoe covers were designed to protect the shoes rather than the patient?

Ive been not wearing covers in keeping with whatever everyone else is doing at the places I rotate, but I find this odd as obviously, there are ALWAYS boxes of shoe covers right next to the masks.

Thoughts?

I usually have a specific traumatic event ifrom my past that I can bring up to the med students, followed by "and that's why I always wear shoe covers," or "and that's why I always wear eye protection." Even so, I find myself occasionally slipping. Now I tend to try to gauge the messiness or potential for irreversible damage, then make an individualized decision.


Still, I remember being an intern during a late Saturday call night, assisting my boss on an Ex Lap for perforated bowel......the patient's belly was full of stool. He was in the lithotomy position, and I was assisting from the foot of the table. I didn't look down for a while, and then suddenly realized I'd been standing in crap for about 3 hours....ankle deep......

......and that's why I always wear shoe covers....on acute abdomen cases.....

 

[Castro Viejo]

Screw shoe covers. I wear the calf-high space boots always. Bowel, trauma, and now, vascular.

Those shoe covers aren't impermeable. It's left stains and stuff on my sneakers and THAT'S WHEN I STARTED WEARING THE CALF-HIGHS.

 

[DoctaJay]

Interestingly, there is a pulm attending that wears shoe covers when hes in the OR for a bronch.....BUT NO SHOES!

disgusting. I hate those bloodly things cause they barely fit over my shoes. I wear size 13s which is not even that big so I'm not sure why I'm always stretching the fibers of the cover to get them on.

 

[GeraldMonroe]

I think that's pretty funny the idea of a doc going into the O.R. shoeless. I take it that this is against policy, due to the danger of a dropped instrument infecting you with a bloodborne disease?

 

[Buckeye(OH)]

I think that's pretty funny the idea of a doc going into the O.R. shoeless. I take it that this is against policy, due to the danger of a dropped instrument infecting you with a bloodborne disease?

I dont know about policy. I do know its straight gross because those low shoe covers do let some goo in.

 

[thunder hawk]

one particular incident which I like to quote over here..... I was in third yr of medical school in my home country and was doing my ortho rotation. I was observing the case while two ortho surgeons were working on the bone. They were using chisel and hammer. As one of them banged the chisel with the hammer, the chisel slipped from his hand, flew like a spear and hit the dorsum of other guy who was unfortunately wearing open shoes. He had an approx 10x10cm laceration on his foot and immediately started to bleed like anything. To make matters worse, patient was HBV post. I dont need to mention about what happened next but the lesson learnt was that its not only imp to wear shoe covers but also some calf high thick rubber shoes that are impermeable to surgical instuments.

 

[ddmo]

My favorite is the attendings who where these:

I personally wear the tall covers for all ortho cases because I hate blood on my pants.

 

[GeraldMonroe]

Aren't those things incredibly hot and uncomfortable? Just how often does a lake of blood and poop and other body fluids end up swamping the floor anyway?

I'm thinking owning several pairs of the cheaper 'super-comfy' shoes (danskos or whatever) and leaving an extra pair in a locker with some extra socks would be a better plan. Just make sure to wash the shoes in the washer with bleach...

 

[maxheadroom]

Aren't those things incredibly hot and uncomfortable? Just how often does a lake of blood and poop and other body fluids end up swamping the floor anyway?

I'm thinking owning several pairs of the cheaper 'super-comfy' shoes (danskos or whatever) and leaving an extra pair in a locker with some extra socks would be a better plan. Just make sure to wash the shoes in the washer with bleach...

I'm not sure what your metric is for "cheap", but Danskos run in the $120 range. I have my old ones stashed in my locker at the main OR (where I rarely work) and keep my good ones at the ASC.

 

[Thanatos]

Works for me. Comfortable and no blood on the socks...

 

[Docgeorge]

I agree 100% although I dont wear my nice ones into the OR unless I'm comming in from home and in a rush. I have a very nice and relatively cheap (for boots anyway) pair of Redwing boots that are my operating boots.

 

[ddmo]

Aren't those things incredibly hot and uncomfortable? Just how often does a lake of blood and poop and other body fluids end up swamping the floor anyway?

I'm thinking owning several pairs of the cheaper 'super-comfy' shoes (danskos or whatever) and leaving an extra pair in a locker with some extra socks would be a better plan. Just make sure to wash the shoes in the washer with bleach...

It's not so much about swamping the floor as blood dripping down the drapes or dripping down your gown onto your pants and shoes, or even splashing off the floor.

As to how often this occurs, it depends on the surgery. Total joints or hip fractures, pretty common. Pediatric hernia repair, just about never.

 

[pRotAgOnIsT]

Works for me. Comfortable and no blood on the socks...

Yup. Boots all the way. The blood is usually already dry by the time I reach the bar and order my first beer.

 

[SpineKing]

Time was when booties were worn by everyone, no ifs, ands or buts about it. That was in the days when it was actually believed that it made a profound difference in the post op infection rate. Now most hospitals simply allow staff to bring a dedicated pair of shoes for surgery. I recommend good sneakers with extra padding. Add the shoe coves afterward if you wish, but the padding is paramount.

 

[Buckeye(OH)]

I've also heard from a couple of people that I should wear TED stockings on OR days....thoughts?

 

[Winged Scapula]

Graduated compression stockings are good for preventing the spiders and VV that even males get. They are expensive, hard to get on and hot but your legs may feel better.

 

[Dr. Dukes]

A couple of months ago Runners World ran an article about knee high compression socks marahoners are starting to wear (same issues).
They mentioned two different companies socks but didn't recommend one or the other.
I don't have the info with me now, but will post t when I get home, been meaning to and just forgot.
The socks run $25 or $30 depending on which brand you use.
Certainly a less expensive (and hopefully a just as good) option.

 

[diphenyl]

I learned about shoe covers the hard way. Was a 4th year helping with an attending in a community hospital, has a guy with a GSW to the chest that coded while I was suturing a chest tube in. Attending starts the thoractomy and this guys entire volume drenched my shoes, socks, and pants.

 

[CME2P]

A couple of months ago Runners World ran an article about knee high compression socks marahoners are starting to wear (same issues).
They mentioned two different companies socks but didn't recommend one or the other.
I don't have the info with me now, but will post t when I get home, been meaning to and just forgot.
The socks run $25 or $30 depending on which brand you use.
Certainly a less expensive (and hopefully a just as good) option.

i wear sigvaris and love them. they decrease fatigue and my legs don't hurt at night when i've been up all day, but ws is right they get hot sometimes

 

[GeraldMonroe]

I'm still skeptical about the waders/boots.

It seems like a clear tradeoff : you could have a super-comfy "primary" pair of shoes and a secondary backup pair for those times when the primary pair gets doused in something (some old sneakers or something as backup...no reason to have Danskos as a backup pair).

Or you could wear hot and uncomfortable waders/cowboy boots all the time, trading dry socks for constant discomfort.

It all depends on how often you end up wading through blood showers and poop puddles in a given year as a doctor, I guess. And just how much it bothers you to feel the poop/blood/urine squelching between your toes until you get a chance to change...

 

[maxheadroom]

Time was when booties were worn by everyone, no ifs, ands or buts about it. That was in the days when it was actually believed that it made a profound difference in the post op infection rate. Now most hospitals simply allow staff to bring a dedicated pair of shoes for surgery. I recommend good sneakers with extra padding. Add the shoe coves afterward if you wish, but the padding is paramount.

I would recommend against sneakers or soft-padded shoes. Sneakers are made for active use, not standing in one place. When I was an M3 I had constant problems with lower back pain and quad/hamstring tightness. One of the surgery residents told me to try a hard-soled clog instead of sneakers. I was a bit reluctant, but I dropped $120 on my first pair of Danskos. I'm a big believer. One of the spine guys explained it to me, but I didn't really follow it. All I know is I can stand in place all day long in Danskos and my back and legs are fine. If I do the same in sneakers, I hurt all over.

 

[Buckeye(OH)]

This is not good news because I swore I would never wear Danskos. Just something about me personally, wearing clogs, doesn't seem right.

 

[Winged Scapula]

This is not good news because I swore I would never wear Danskos. Just something about me personally, wearing clogs, doesn't seem right.

I never wore clogs either - not during medical school or residency until a friend purchased me some Merrells. I frankly didn't find them any more comfortable than my NB sneakers (and unlike others never had back or other pain in the OR), but I liked being able to slip my feet out of them.

So now I wear Merrells clogs and although they aren't anymore comfortable for me, I do prefer them for the simple reason of ease of getting on and off.

 

[SocialistMD]

This is not good news because I swore I would never wear Danskos. Just something about me personally, wearing clogs, doesn't seem right.

Cowboy boots (as mentioned above). Think about it; cowboys are on their feet all day, every day, in some very unforgiving terrain. Their boots have stood the test of time to be comfortable in those conditions. They work in the OR, too. Granted, I don't wear them, but it is because I like to be able to slip my feet out of my shoes, but the people I know who wear them swear by them and it makes sense.

 

[Smurfette]

I honestly have never seen anyone wear cowboy boots in the OR.

whatever shoes can tolerate standing for hours at a time on a hard floor, should work well. Merrells, Danskos, Crocs are most popular where I am, and have much longer lives than other shoes (my danskos are 5 yrs old and no where near worn out--except that I replaced the insoles for $8 a yr ago). Think of shoes that are easier to clean, its hard to get blood out of a nice pair of sneakers.
TEDs are a good idea, too, they do make your legs feel better at the end of a long call or long case.

 

[Winged Scapula]

I've seen the cowboy boots in the OR. Wearers swear they are comfortable and for those of you vertically challenged, they give a bit more height than clogs.😀

 

[MossPoh]

Most cowboy boots take some serious breaking in. I had some when I did farm work and they were miserable for a while. I felt like the socks were far more important than the boots. As to how it would translate to surgery, I obviously can't comment.

 

[maxheadroom]

I know several guys who wear cowboy boots in the OR. They all swear that they are the most comfortable thing ever.

 

[GeraldMonroe]

for those of you vertically challenged, they give a bit more height than clogs.😀

Is it better to be tall or short as a surgeon?

I'm guessing it's best to be the same height as the average attending, since the table height can be adjusted.

 

[Winged Scapula]

Is it better to be tall or short as a surgeon?

I'm guessing it's best to be the same height as the average attending, since the table height can be adjusted.

It makes no difference for the vast majority of cases once you are an attending and can adjust the table height to the comfortable place you are.

As a junior resident, it helps to be the same height as your attending. I hated peds surg because it was apparently a requirement to be above 6'4" in my residency but loved operating with the PD because he and I were about the same height (and had the same taste in music).

In some cases, like bariatrics, I can help to be tall so you can look into the depths (and reach in if not doing lap) without standing on a step or having your arm in to the shoulder when mobilizing the colon.

 

[Dr. Dukes]

A couple of months ago Runners World ran an article about knee high compression socks marahoners are starting to wear (same issues).
They mentioned two different companies socks but didn't recommend one or the other.
I don't have the info with me now, but will post t when I get home, been meaning to and just forgot.
The socks run $25 or $30 depending on which brand you use.
Certainly a less expensive (and hopefully a just as good) option.

Much delayed, sorry...
The article: http://www.runnersworld.com/article/0,7120,s6-240-320--13079-0,00.html.
A good friend of mine wore Oxysox in the Boston Marathon a couple weeks back and said they stayed up the whole time (article says they're not as good as another brand), so if they stay up in a 2:40 marathon they probably stay up in the OR.

 

[GeraldMonroe]

Can't short people ever catch a break? Is there any advantage to being a short surgeon? (yes, I'm of below average height)

 

[DHT]

Can't short people ever catch a break? Is there any advantage to being a short surgeon? (yes, I'm of below average height)

Less likely to get varicose veins from the hours of standing?

 

[skiz knot]

My favorite is the attendings who where these:

I personally wear the tall covers for all ortho cases because I hate blood on my pants.

Very handy on arthroscopy cases. There is no way that hanging plastic triangle shaped bag is going to catch all the water.

😀