Background

Effective communication is critical for patient safety and surgical outcomes inside the operating room (OR). Labeled surgical caps have been proposed as a strategy to improve intraoperative communication and teamwork by facilitating name and role recognition among surgical staff. However, concerns regarding potential surgical site infections (SSIs) have limited their widespread adoption and to this day hindered their use across Europe.

Methods

The MEDLINE/PubMed database was searched for peer-reviewed articles reporting on the use of labeled surgical caps and at least one outcome of interest (communication, teamwork, surgical site infections, costs, or environmental impact) from database inception to April 2025. Findings were synthesized qualitatively.

Results

Reusable labeled surgical caps improve interdisciplinary communication and name recognition in the operating room, thereby promoting effective teamwork. This effect is particularly relevant in robotic surgery, where the primary surgeon operates from a remote console. Current evidence does not indicate an increased risk of SSIs, with multiple studies reporting no significant difference in infection rates between reusable and disposable surgical headwear.

Conclusions

Reusable, labeled surgical caps should be implemented across the globe to improve communication and ultimately patient safety. They align with green hospital goals by reducing waste and long-term costs. Additionally, they also provide opportunity for stronger identification with the institution. Current regulations restricting their use are not supported by existing evidence and should be re-evaluated. Prospective studies also from European clinical settings may help to establish future policy updates and to further evaluate the microbiological safety of reusable surgical caps.