Walk into a pre-op huddle and you will see the ritual play out with almost ceremonial grace: hands scrubbed to the elbows, cuffs secured, masks tied, and—quietly but decisively—rings, earrings, and watches surrendered to a locker or a small velvet pouch. As a jewelry connoisseur who has spent years in conversation with perioperative leaders and professional piercers, and as a storyteller devoted to the craft of adornment, I can say this plainly and with love for both worlds: the operating room rewards restraint. Beauty thrives on context, and in surgery the highest expression of excellence is a perfectly clean field, uncompromised hand hygiene, and equipment that moves without a snag.
This is not a treatise against jewelry. It is a field guide for surgeons who adore it and who also honor the imperatives of sterile practice. Below, I distill the evidence and the practical wisdom that OR teams live by, then translate it into material and design choices that respect your profession and your personal style.
Inside the OR: The Rule Is Removal
In the restricted world of the operating room, credible authorities converge on a single principle: remove jewelry. Professional guidance anchored in the Association of periOperative Registered Nurses emphasizes taking off all hand and arm adornment before scrubbing, primarily to preserve hand hygiene and glove integrity. The Royal Australasian College of Surgeons has aligned with World Health Organization and national safety bodies in recommending that jewelry, including rings, be removed in high‑risk settings such as operating theaters. The rationale is straightforward. Rings, bracelets, and watches harbor microorganisms that can resist typical scrubbing, and multiple studies have documented higher bacterial counts around jewelry sites. In parallel, wearing rings under gloves correlates with more glove microtears and perforations, a risk that is not solved by double‑gloving. When you are working within a sterile field, the safest jewelry is none.
There is another, less frequently encountered hazard: energy and heat. Electrosurgical units, defibrillation, and warming devices have historically inspired fears of current tracking to metal jewelry. Seasoned OR educators will tell you the primary, everyday danger is contamination rather than conduction, and that electrosurgical burns linked to staff jewelry are rare when equipment is properly used with correctly placed return electrodes. Even so, perioperative policies favor eliminating avoidable variables when the stakes are patient safety, which is why the default remains removal.
The Wedding Band Dilemma
The question that makes even the most stoic scrub sink pause is the wedding band. Many facilities now have zero‑tolerance language around rings; others carve out a narrow exception for a single plain band, sometimes taped. The science here is nuanced. Observational work shows rings can increase microbial burden and are linked to higher glove perforation rates. Yet at least one controlled study found no significant difference in bacterial counts on hands with versus without a single plain ring after proper hand hygiene. This conflicting evidence sometimes drives the small, cautious exception for wedding bands at the policy level.
From a surgeon’s perspective, the practical conclusion is less conflicted. Your facility’s written policy governs, and the momentum of national guidance is toward complete removal in the OR. If your hospital still permits a plain band, the safest compromise is a smooth, low‑profile ring with no stones and no engraving on the outer surface, worn only where explicitly allowed and never under sterile gloves unless policy and OR leadership agree. Even then, remember that “allowed” and “advisable” are not synonyms; the ring that delights at dinner should rest during a case.
Earrings, Necklaces, and Facial or Body Piercings
Head and neck adornments introduce particle‑shedding, snag, and foreign‑object risks in a space where airflow, draping, and movement are tightly controlled. Many facilities prohibit earrings and necklaces in restricted areas or require them to be fully covered by caps or hoods; dangling styles are particularly problematic. Oral piercings can impede intubation, and facial jewelry can interfere with secure mask fit. Best practice in the OR is removal of body jewelry entirely. Professional piercers sometimes offer nonmetal retainers to keep a channel from closing, but those retainers are not sterile and can dislodge. If a fresh piercing or anatomic complexity makes removal challenging, escalate early to perioperative leadership: the answer is often still removal, and when exceptions are considered they must be deliberately documented and managed.
Watches and Bracelets
Wrist adornment is both beloved and impractical in the OR. Watches and bracelets trap debris, impede thorough hand and forearm scrubbing, and add snag points near drapes and devices. Infection‑prevention guidance treats them the same as rings—remove before scrubbing. Timekeeping lives on wall clocks, timers, and anesthesia monitors while you operate, and your watch can return for the walk back to clinic.
Outside the Sterile Field and in Clinic: Understated, Clean, and Functional
Surgeons do far more than operate. Pre‑op consults, post‑op checks, clinics, and administrative meetings often have dress codes governed less by sterility and more by professionalism and patient safety. In these settings, the jewelry rule is discretion. Clinical hygiene policies still flag rings and bracelets as high‑risk because they complicate handwashing, yet small, flush‑to‑the‑lobe studs and short, close‑to‑neck chains are often acceptable for non‑procedural work. Patient‑facing roles also benefit from designs that neither clang nor flash under bright lights or on camera. When in doubt, reduce both scale and count. Choose materials that are easy to sanitize, and reserve porous textiles and intricate stones for off‑duty wear.
Quick Reference by Setting
Setting |
Rings |
Earrings |
Necklaces |
Bracelets/Watches |
Body Piercings |
Notes |
Scrubbed in sterile field |
Remove; some policies permit a single plain band but trend is removal |
Remove; head/neck items typically prohibited |
Remove |
Remove |
Remove; retainers are not sterile and often discouraged |
Defer to written OR policy and AORN‑aligned hand hygiene guidance |
Restricted area, not scrubbed |
Often remove hand/arm jewelry; small studs may be disallowed or must be fully covered by caps/hoods |
If allowed, keep small and fully covered |
Usually discouraged; if allowed, keep short and tucked |
Often discouraged; policy‑dependent |
Generally discouraged; seek leadership approval |
Minimize motion, noise, and snag risk; maintain thorough hand hygiene |
Clinic and office |
Prefer a simple band or a silicone alternative; remove for procedures |
Small, flush studs are usually acceptable |
Short chain, no pendant, tucked under collar |
A clean, low‑profile watch with a silicone or fabric strap is practical; remove for patient care that requires gloving |
Avoid visible facial jewelry for procedures; discuss policy for others |
Keep designs easy to clean; remove and store before procedures |
These patterns reflect recurrent policy themes across hospitals and professional bodies. Your facility’s dress code and infection‑control program prevail, so review those documents and ask your OR educator when in doubt.
Materials and Design Choices That Play Nicely With Scrub Life
A surgeon’s jewelry capsule is not about austerity; it is about mastery. For pieces worn outside the sterile field—or off duty—favor alloys and designs that resist sweat, disinfectants, and constant handwashing. Surgical stainless steel, particularly 316L, and titanium have earned their standing for their corrosion resistance and skin tolerance, a point reinforced by medical guidance on safe jewelry for piercings from reputable clinical sources. Solid gold is also a sound choice in simple, smooth profiles when it is kept free of crevices that trap residue. Avoid porous materials at work—fabric bands, wood, rough leather, braided threads—which can harbor microorganisms despite cleaning.
Design is as important as metal. Choose low‑profile bands, flush or bezel‑set stones rather than tall prongs, and continuous surfaces without recesses that hoard soap or skin. The bracelet that sings at a gala rarely harmonizes with a stethoscope or a cuff. In clinics, a lightweight watch with a silicone or fabric strap cleans easily and dries fast, and it does not clatter on exam tables. For rings that you cherish but should not bring into a procedural room, consider a silicone travel band for commuting and a dedicated storage plan once you change into scrubs.
Care, Storage, and a Day‑of‑Surgery Ritual
The best jewelry care routine for surgeons is a choreography that respects both craft and clinic. On days you operate, leave nonessential pieces at home. For the few things you must carry, create redundancy: a small ring keeper that clips inside a locker, a labeled pouch that rides in your bag, and a simple sign‑off step in your pre‑scrub ritual. OR educators often recommend facilities provide secure storage and standardize signage and checklists; that is not merely administrative. It guards against loss and softens the tension between symbolism and safety.
Cleaning should be boring and regular. After clinics or meetings, rinse steel, titanium, and gold with mild soap and warm water, then dry thoroughly with a soft cloth. Avoid bleach and harsh chlorine on steel and titanium, which can mar finishes over time, and keep ultrasonic cleaners and aggressive polishes away from delicate settings unless a jeweler has advised their use. Inspect prongs and clasps periodically, and repair promptly; loose stones love glove fingertips and jacket linings more than you do.
The Electrosurgery Question, Answered with Nuance
Electrosurgical units and defibrillators carry an aura that magnifies every metallic glint. Outpatient OR coverage has warned of stray burns where current seeks unexpected pathways, and oral jewelry can complicate airway management. Seasoned OR voices have countered that properly configured equipment and correctly placed return electrodes make jewelry‑mediated burns rare, and that the daily safety conversation belongs to hand hygiene and glove integrity. Both perspectives are true, and together they argue for the same result. Remove jewelry when you will be anywhere near a sterile field or energized devices. It is not a moral judgment on adornment; it is a professional embrace of control in a high‑consequence environment.
Definitions, Demystified
Operating room attire refers to the garments and accessories worn in semi‑restricted and restricted perioperative areas. It is not fashion; it is a barrier system designed to keep skin, hair, and fabric particles from migrating into the field where a patient’s body is open to the world.
Surgical hand antisepsis is the rigorous cleaning of hands and forearms before donning sterile gloves and gown. Its success depends on skin contact and friction; rings, watches, and bracelets break that contact and shelter microorganisms in creases the scrub brush cannot reach.
An electrosurgical unit is a device that uses electrical current to cut tissue and control bleeding. A return electrode safely completes the circuit. When these elements are properly configured, energy burns via jewelry are uncommon; nonetheless, removing metal reduces any residual risk.
Healthcare‑associated infections are infections a patient acquires while receiving care in a medical facility. The organisms that worry infection‑prevention teams include a cluster known as ESKAPE pathogens, species infamous for evading treatment and thriving in hospital environments.
A retainer in body art is a nonmetal placeholder used to keep a piercing channel open when jewelry must be removed for a medical reason. Professional piercers and body‑modification experts note that retainers are not sterile implants, and clinical teams treat them cautiously, especially near surgical masks or drapes.
Peripheral venous access is the placement of an IV line into a peripheral vein to administer fluids and medications or for monitoring. Bracelets and tight cuffs can get in the way; jewelry should never delay access in an emergency.
Medical tape in this context is a hypoallergenic, skin‑safe adhesive used to secure dressings or momentarily immobilize an item. Patient‑facing guidance sometimes allows taping jewelry a patient cannot remove, but for staff in the OR, taping is not a replacement for proper removal.
Evidence and Authority in Brief
When you look beyond folklore, a consistent pattern emerges. OR‑specific guidance stresses that all hand and arm jewelry should come off before scrubbing. The World Health Organization’s hand‑hygiene frame and the Royal Australasian College of Surgeons’ position emphasize removal of jewelry, including rings, for surgical settings. Outpatient surgical commentary from AORN stresses that body jewelry in the OR is incompatible with sterility and can complicate intubation and emergency defibrillation, with an added practical caution that many body‑art studios do not use implant‑grade metals.
Observational studies of healthcare workers frequently report that rings and watches are worn despite policy and that the areas under them carry higher microbial loads. In one report, the proportion of staff wearing jewelry dropped when unit leadership intervened, a reminder that culture and systems matter. The conversation about a single plain band is the one place where evidence is mixed. Experimental work has shown that proper alcohol rub or soap‑and‑water techniques can reduce bacterial counts to similar levels with or without a single plain ring. At the same time, glove‑failure data and the logic of eliminating reservoirs during surgical hand preparation continue to drive policies toward complete removal. Across sources, you will find an operational throughline: educate clearly, store securely, remove consistently, and stop misinformation at the door.
Buying With Intention: Tips for Surgeons and Surgical Residents
It is entirely possible to curate a collection that loves the work you do. Start with a band you will not miss while scrubbed—perhaps a slim, perfectly smooth ring for life outside the OR and a silicone stand‑in for commutes. If you wear piercings, keep your jewelry site‑specific and professionally sized, and favor materials recognized by clinical guidance for new piercings, namely surgical steel, gold, or titanium. Avoid nickel‑heavy or brass‑plated pieces that can provoke irritation. In clinics, select a clean, low‑profile watch on a strap that tolerates frequent handwashing, and retire jangly bracelets in favor of a single, quiet cuff only when policy allows. Keep one small, labeled pouch for clinic days and one locker‑friendly keeper for OR days, and let the ritual of moving jewelry to its shelter become as practiced as tying your mask.
If your work brings you near imaging or hybrid suites, remember that metal can create artifacts on CT and can appear on X‑rays. High‑quality body jewelry is often non‑ferromagnetic, but verification belongs with radiology and perioperative leadership. The safe rule is the same: remove it unless a documented exception exists, and never let accessories interfere with a scan or a sterile step.
A Short FAQ, Answered with the OR in Mind
Can I wear a silicone ring under my sterile gloves?
The safest answer is no. Rings of any material can increase glove perforation and complicate surgical hand antisepsis. Follow your facility’s policy, which commonly requires removal before scrubbing.
Are clear plastic retainers acceptable for my nostril or cartilage piercing while I operate?
Retainers help patients keep a channel open during procedures, but they are not sterile implants. In staff, retainers near masks and drapes are typically discouraged; remove them unless your OR leadership has given a documented exception and a way to fully cover them.
If a ring is stuck, can I tape it and scrub?
Patient guidance sometimes allows taping when removal is impossible. For staff, taping is not a substitute for removal because it does not solve hand‑hygiene or glove‑integrity issues. If you cannot remove a ring, escalate early to your OR leadership for a safe plan.
What should I tell trainees who are worried about losing their wedding band?
Normalize the concern, then solve the logistics. Provide or suggest ring keepers or lockers, include jewelry removal in orientation checklists, and reinforce policy during case huddles. It respects both the symbol and the sterile field.
Closing
Jewelry is a language of commitments—many of them precious. Surgery is a language of commitments as well, to sterility, to vigilance, to perfection in moments that cannot be repeated. When those languages meet, grace looks like removal in the OR, discretion in clinic, and design choices that withstand the realities of care. Honor the ritual, and your pieces will accompany you for a lifetime, shining brightest when you choose exactly when not to wear them.
References
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11316805/
- https://www.southtexascollege.edu/academics/visual-arts/safety/jewelry.html
- https://safepiercing.org/preparing-for-medical-dental-procedures/
- https://www.aorn.org/outpatient-surgery/article/2012-December-safety-protect-patients-with-piercings
- https://www.surgeons.org/about-racs/position-papers/jewellery-in-the-operating-theatre-2022
- https://www.columbiadoctors.org/health-library/article/body-piercing-safe-jewelry-choices/
- https://www.ast.org/uploadedfiles/main_site/content/about_us/standard%20wearing%20jewelry.pdf
- https://allnurses.com/jewelry-or-misinformation-t225801/
- https://bodyartforms.com/blog/guide-to-piercing-retainers-for-surgery-and-medical-procedures?srsltid=AfmBOoo6gpACM5UMqT1e3bQhSw4H0-M05B4xroPEOCTMNKMzihurS-R2
- https://brillomiami.com/surgical-steel-jewelry/?srsltid=AfmBOoqPjPYLjfC1sm1f614IiZa3BK1Q0X1SF2g9uf9fNmw4Ih-bcvB_
