MULTICENTER RANDOMIZED DOUBLE BIND CROSSOVER TRIAL ON CONTAMINATION OF CONVENTIONAL TIES AND BOW TIES IN ROUTINE OBSTETRIC AND GYNECOLOGICAL PRACTICE

Objective-To assess level of contamination of neckwear worn by gynecol ogists and obstetricians during routine working week. Design-Multicent re randomised double blind crossover trial. Participants wore the same conventional ties for three days in one week and bow ties for the sam e period in second week. Setting-Two teaching and three district gener al hospitals in the midlands, Wales, and north England. Subjects-15 re gistrars and senior registrars. Interventions-A swab soaked in sterile saline was taken from specific area on ties at end of first and third working days and sent in transport medium for culture on chocolatised blood and Macconkey agar for 48 hours. Main outcome measures-Level of bacteriological growth assessed semiquantitatively (0 for no contamin ation; +++ for heavy contamination) after swabs had been cultured. At end of study the participants completed a questionnaire to assess thei r attitude toward wearing different types of necktie. Results-12 docto rs (80%) completed the study. Although bow ties were significantly les s contaminated at end of first working day (z= -2.354, p=0.019), this difference was not maintained; there was no difference in level of con tamination on third day. Level of contamination did not increase betwe en first and third day of wearing the same garment. One of the 10 doct ors who returned the questionnaire found the bow tie very uncomfortabl e. All participants would consider wearing a bow tie if it proved to b e less contaminated than a conventional tie. Conclusions-Although a si gnificant difference in contamination was established between conventi onal and bow ties on first day of study, this difference was not confi rmed on third day and there is unlikely to be any real association bet ween tie type and bacterial contamination. Because of its negative ima ge and difficulty to tie, the bow tie will probably remain a minority fashion.