|This video reported the highlights of an editorial by Arthur Firstenberg concerning masks. Firstenberg is a scientist and journalist who attended Cornell Medical School for four years but did not finish due to illness.
“As a person who went to medical school, I was shocked when I read Neil Orr’s study, published in 1981 in the Annals of the Royal College of Surgeons of England. Dr. Orr was a surgeon in the Severalls Surgical Unit in Colchester. And for six months, from March through August 1980, the surgeons and staff in that unit decided to see what would happen if they did not wear masks during surgeries. They wore no masks for six months and compared the rate of surgical wound infections from March through August 1980 with the rate of wound infections from March through August of the previous four years. And they discovered, to their amazement, that when nobody wore masks during surgeries, the rate of wound infections was less than half what it was when everyone wore masks.”
Surprised at this outcome, Firstenberg decided to look further to see if this was a fluke or if other studies had demonstrated the same effect. And they had.
And here are some of the studies he found:
“The wearing of a surgical face mask had no effect upon the overall operating room environmental contamination and probably work only to redirect the projectile effect of talking and breathing. People are the major source of environmental contamination in the operating room.”
“To examine the efficacy of currently used synthetic-fiber disposable face masks in protecting wounds from contamination, human albumin microspheres were employed as “tracer particles,” and applied to the interior of the fact mask during 20 operations. At the termination of each operation, wound irrigates were examined under the microscope. Particle contamination of the wound was demonstrated in all experiments. Since the microspheres were not identified on the exterior of these face masks, they must have escaped around the mask edges and found their way into the wound. The wearing of the mask beneath the headgear curtails this route of contamination.”
“Although cardiac catheterization-related infections are rare, caps and masks are often worn to minimize this complication. However, documentation of the value of caps and masks for this purpose is lacking. We, therefore, prospectively evaluated the experience of 504 patients undergoing percutaneous left heart catheterization, seeking evidence of a relationship between whether caps and/or masks were worn by the operators and the incidence of infection. No infections were found in any patient, regardless of whether a cap or mask was used. Thus, we found no evidence that caps or masks need to be worn during percutaneous cardiac catheterization.”
“It has never been shown that wearing surgical face masks decreases postoperative wound infections. On the contrary, a 50% decrease has been reported after omitting face masks…These results indicated that the use of face masks might be reconsidered. Masks may be used to protect the operating team from drops of infected blood and from airborne infections, but have not been proven to protect the patient operated by a healthy operating team.”
“The evidence for discontinuing the use of surgical face masks would appear to be stronger than the evidence available to support their continued use.’
“Surgical face masks worn by patients during regional anaesthesia did not reduce the concentration of airborne bacteria over the operation field in our study. Thus they are dispensable.”
From a review:
“We previously verified “no difference in the probability of developing the first episode of peritonitis without mask” and “no difference in the total number of episodes of peritonitis between patients performing bag exchange ‘with’ and ‘without’ face mask” (1). Furthermore, on Cox proportional hazard regression, “face mask had no protective effect for the occurrence of the first episode of peritonitis” (1). The current study shows that the occurrence of peritonitis in patients performing bag exchanges without a face mask is not different from that reported by other centers (2,3).
Eliminating the face mask would reduce CAPD costs (4,5) and would simplify the bag exchange procedure and the training of patients and assistants, thus adding to therapy success. The face mask may be an added annoyance to unaccustomed individuals during the bag-exchange procedure. Besides, hand contamination may result when the patient tries to correctly position the mask or involuntarily touches it. Adequate hand-washing, and not the act of wearing face mask, may possibly be the most important factor in infection control (6).
It has long been known that S. aureus nasal carriers are also skin carriers (7), and that bacteria may be transferred from hands to the exit site and the CAPD tubing during bag exchange. In this case, the wearing of a mask will not prevent peritonitis. Instead, the mask may be a source of bacterial contamination, from rubbing against the face (8).
The subject of this study—use of a face mask and prevention of infection—is an important and much neglected issue. McLure et al (9) suggested that wearing a face mask prevented downward dispersal of upper respiratory tract bacteria into agar blood plates during talking and head turning. However, a 50% reduction in surgical wound infection has been reported when masks were not in use (10).”
“No significance difference in the incidence of postoperative wound infection was observed between masks group and groups operated with no masks. There was no increase in infection rate in 1980 when masks were discarded. In fact there was significant decrease in infection rate. From the limited randomized trials it is still not clear that whether wearing surgical face masks harms or benefit the patients undergoing elective surgery.”
Surgeons at the Karolinska Institute in Sweden stopped requiring face masks in 2010 for anesthesiologists and other non-scrubbed personnel in the operating room. ‘Our decision to no longer require routine surgical masks for personnel not scrubbed for surgery is a departure from common practice. But the evidence to support this practice does not exist,’ according to Dr. Eva Sellden.
“Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.”
Two Cochrane Reviews concluded that “There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials.”
“…overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination.”
“Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.”
 https://naturallyhealthynews.com/masking-the-truth/ accessed 10.3.2020
 Orr NW. “Is a mask necessary in the operating theatre?” Ann R Coll Surg Engl 1981 Nov; 63(6): 390–392.
 Ritter MA, Eitzen H, French ML, Hart JB. “The operating room environment as affected by people and the surgical face mask.” Clin Orthop Relat Res 1975 Sep;(111):147-50.
 Ha’eri GB, Wiley AM. “The efficacy of standard surgical face masks: an investigation using “tracer particles.”” Clin Orthop Relat Res 1980 May;(148):160-2.
 Laslett LJ, Sabin A. “Wearing of caps and masks not necessary during cardiac catheterization.” Cathet Cardiovasc Diagn 1989 Jul;17(3):158-60.
 Tunevall TG. “Postoperative wound infections and surgical face masks: a controlled study.” World J Surg May-Jun 1991;15(3):383-7; discussion 387-8.
 Skinner MW, Sutton BA. “Do Anesthetists Need to Wear Surgical Masks in the Operating Theatre? A Literature Review with Evidence-Based Recommendations.” Anaesth Intensive Care 2001Aug;20(4):331-338
 Lahme T, Jung WK, Wilhelm W, Larsen R. “[Patient surgical masks during regional anesthsesia. Hygienic necessity or dispensable ritual?” Ansethesist 2001 Nov;50(11):846-51
 Figueiedo AE, Poli de Figueiredo CE, d’Avila DO. “Bag Exchange in Continuous Ambulatory Peritoneal Dialysis Without Use of a Face Mask: Experience of Five Years.” https://www.advancesinpd.com/adv01/21Figueiredo.htm
 Bahli ZM. “Does evidence based medicine support the effectiveness of surgical facemasks in preventing postoperative wound infections in elective surgery?” J Ayub Med Coll Abbottabad Apr-Jun 2009;21(2):166-70.
 Selldon E, Hemmings HC. “Is Routine Use of a Face Mask Necessary in the Operating Room?” Anesthesiology 2010 Dec;113(6)
 Webster J, Croger S, Lister C, Doidge M, Terry MJ, Jones I. “Use of face masks by non-scrubbed operating room staff: a randomized controlled trial.” ANZ J Surg 2010 Mar;80(3):169-73.
 Vincent M, Edwards P. “Disposable surgical face masks for preventing surgical wound infection in clean surgery.” Cochrane Database Syst Rev 2014;(2):CD002929.
 Da Zhou C, Sivathondan P, Handa A. “Unmasking the surgeons the evidence base behind the use of facemasks in surgery.” JR Soc Med 2015 Jun; 108(6): 223–228.
 Salassa TE, Swiontkowski MF. “Surgical attire and the operating room: role in infection prevention.” J Bone Joint Surg Am 2014 Sep 3;96(17):1485-92.