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, like medical face mask:

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 gown disposable 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 and face mask. 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 sterile surgical gowns and the last two types are related to high temperature method used for reusable surgical gowns with surgical pack. 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