Science behind Surgical Gowns: An Overview


An overview of the various parameters to consider for
producing surgical gowns beginning with raw materials, methods of sterilisation
to building parameters and more.  

Surgical gowns used by medical professionals are essential
protective equipment for securing one’s health from various pathogens such as
bacteria, viruses. If the pores of the garments are less than the size of the
microbes, micro-organisms cannot pass through it. For producing garments,
manufacturers have to be concerned about the specification, comfort and cost of
the products. It is really difficult to incorporate each criterion. But
manufacturers always try to develop their methods depending on global response.
This article discusses classification of the surgical gowns based on fabric types
and factors considered for their production process.

Classification on the basis of fabrics

According to fabric types, surgical gowns can be
classified into three types:

Cotton/cotton-polyester: These are traditional fabrics having large pore
sizes through which micro-organisms can easily pass leading to poor barrier
effects. For providing better barrier quality, tightly woven fabrics should be
blended with polyester and long staple cotton and treated with liquid repellent
fluorocarbons. These kinds of fabrics are reusable but need to be applied by a
repellent finishing agent for enhancing the barrier effects as it reduces after
each wash.

Microfilament fabrics: These are tightly woven fabrics just like
cotton/cotton-polyester, yet they are made from very fine filaments. They are
subjected to hydrophobic agent during the reprocessing process.

Multilayer fabrics: Multiple layers are used for achieving desirable
objectives here. For example, outer layers are designed to resist abrasion and
puncture, middle layers ensure resistance of fluid penetration and bottom
layers provide comfort to users.

According to usage purposes, the gowns can be divided into
two ways:

Disposable type surgical gowns: These types of surgical gowns
used for one-time purpose, are made by nonwoven techniques. In the US,
disposable surgical gowns and drapes dominate around 90 per cent of the market
place For this single use product, manufacturers sterilise the product and pass
it on to the users. In this way, it is more comfortable to the users and the
barrier quality is also good. But as it is used only a single time, it
increases environmental hazard and cost of the products.

Reusable types surgical gowns: Reusable gowns made from woven
fabrics are used multiple times. It ensures lower clinical wastage and has cost
benefits. But it is difficult to maintain a good barrier life for these gowns
on account of continuous recycling process which makes it unsafe after a point
of time.

Factors Considered for Production Process

There are various parameters involved in surgical gowns
production such as raw materials, methods of sterilisation, building
parameters. 

Raw Materials: Different types of fibre can be used as raw material but
polyester dominates the most because of its availability, comfort, barrier and
costs.

Building Parameters: Besides nonwoven fabrics, plain and twill
structure can be used in surgical gowns. Nowadays, researchers suggest using
plain weave instead of twill weave as twill weave contains large pores between
cross points.

Methods of sterilisation: Sterilisation methods are applied
to fabrics used in surgical textiles for preventing them from catching
infections. There are four types of sterilisation methods which exist
worldwide. They are gas, irradiation, steam autoclave and dry heat. First two
types are low temperature methods used for disposable types of surgical gowns
and the last two types are related to high temperature method used for reusable
surgical gowns. Steam autoclave is widely used because it is effective, safe
and inexpensive but it is not suitable for heat and moisture sensitive fabrics.
Ethylene oxide (Eto) is more suitable for this method but it produces toxic and
long cycles. Thus we can consider two common methods as an alternative to the other
methods – Steris System and the Sterrad system.

Steris System: It is a microprocessor controlled low temperature
sterilisation method that has rapid cycle times of approximately 30 minutes.
The ecofriendly by-products sterilant flows through a flexible endoscope that
facilities salt, protein, and microbe removal. But a small number of
instruments are processed in a cycle.

Sterrad System: The sterilisation system may use the combination of
hydrogen peroxide and low temperature gas plasma with temperature ranges from
45ºc to 50 ºc and operation time cycles time varying from 45 to 70 minutes.
Hydrogen peroxide is known as an antimicrobial agent. Free radicals of hydrogen
peroxide interact with the cell membrane, nucleic acid, or enzymes to break the
life function of micro-organism. This has a small sterilisation chamber of
about 3-5 ft³.

About the Author: Mehedi Hasan Chaion is an undergraduate student of the
Department of Textile Engineering at Jashore University of Science and Technology
(JUST), Jashore, Bangladesh.

References:

(Behera & Arora, 2009) (McCarthy, 2011) (Rutala &
Weber, 1999) Behera, B. K., & Arora, H. (2009). Surgical Gown: A Critical
Review. Journal of Industrial Textiles, 38(3), 205-231.
https://doi.org/10.1177/1528083708091251

McCarthy, B. J. (Ed.). (2011). Textiles for hygiene and
infection control. Oxford: Woodhead Publ. [u.a.].

Rutala, WA, & Weber,
D. J. (1999). Infection control: The role of disinfection and sterilization.
Journal of Hospital Infection, 43, S43-S55. https://doi.org/10.1016/S0195-6701(99)90065-8

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