Cooling vests worn under surgical gowns can make surgeons noticeably more comfortable. In a 2023 randomized crossover trial of 30 orthopedic surgeons, an ice-pack vest cut thermal discomfort by 2.1 points on a 10-point scale and reduced perceived sweating and fatigue, without changing core temperature or cognitive test scores. Vests using ice or phase-change packs suit sterile attire best.

Many hospital areas outside the operating room run cold by design: interventional suites protect equipment and gowned staff, pharmacy cleanrooms control contamination, laboratories and storage areas protect specimens and medicines, and decedent care rooms are refrigerated. Staff in these areas stay warm by layering within each area's garbing rules, adding core warmth, limiting time in the coldest spaces and taking warm breaks.

In the same operating room, gowned surgeons working under lights often feel too warm while less active staff, especially anesthesia clinicians, feel cold. Studies using the ISO 7730 comfort method conclude that no single room temperature can satisfy every role. The most effective fixes are role-specific: cooling for scrubbed surgeons and added insulation or warmth for everyone else, within attire policy.

Cold reduces manual dexterity. A classic review set a finger skin temperature of about 15°C as a minimum for hand function, and newer work shows measurable losses can begin at warmer skin temperatures. Warming the hands, and the whole body, helps preserve performance. Operating rooms are not cold enough to reach those extremes for most staff, but cool, exposed hands can still feel clumsy.

Personal battery devices such as phones, earbuds and heated vests are common in hospitals, but clinical areas add risks that homes do not. Operating rooms can have oxygen-enriched zones where any ignition source matters, and lithium-ion packs can overheat if damaged or charged improperly. Use certified products and approved chargers, clean devices before entering the OR, and follow your facility's electrical and fire safety policies.

AORN's surgical attire guideline allows a long-sleeve scrub jacket, or warm-up jacket, as part of surgical attire and says arms may be covered during patient skin antisepsis. It makes no recommendation on personal clothing under scrubs, leaving fabric and laundering rules to each facility. Scrub attire should be low linting and laundered at a health care-accredited laundry, per state rules, or per CDC recommendations.

In surgical settings, scrub jacket and warm-up jacket usually mean the same garment: a long-sleeve jacket worn over scrubs. It warms the arms and is widely accepted when clean and laundered per policy. A thermal vest warms the core with arms free. The warmest policy-friendly combination for most cold clinicians is a low-lint base layer, a thin core vest and a facility-laundered warm-up jacket.

You can often wear a thin heated or thermal vest under scrubs, but whether it is allowed depends on your facility's policy for personal clothing, fabric and electrical devices. Passive insulated or heat-reflective vests and pockets for air-activated warmers raise the fewest questions. Battery-heated vests may need approval, especially in operating rooms, and every option should be clean, low-lint and comfortable against skin.

To stay warm in the operating room, layer from the skin out within your facility's attire policy: a close-fitting, low-lint base layer under scrubs, a clean warm-up jacket when arms may be covered, and added core warmth such as a thin vest. Cover your head and feet, keep moving between tasks, eat and hydrate, and ask about room temperature between cases.