Clothing Physiology of Surgery

room
Ubaid ur Rehman Eusuf Zai
x080310@utb.hb.se

Smarta Textilier och Högteknologiska Kläder

Smart Textiles and High-Tech Clothing
Clothing physiology of surgery room

SUMMARY:
It has been fundamental practice of the medical practitioners, nurses and
others to avoid coming into contact with the patient’s blood since the
discovery of AIDS, specially for the surgery suite personnels. Surgeon’s
gowns must be impermeable to microbes and blood, but also it needs to
be comfortable in every way. In this assignment we have discussed the
characteristics of a surgical gown that can protect both the surgeon and
the patient from contaminatant like blood, and other foreign particles and
how it can improve the comfort level of the wearer.

PROBLEM FORMULATION:
Working in the operating suite exposes both the patient and the staff,
including the surgeon to several health related risks. Some procedures are
very invasive with large amounts of body fluids involved and some are
regarded as highly risky, such as Orthopaedic and Neurosurgery; others,
perhaps less invasive, are regarded as lower risk.
Surgery gowns plays an important role in protecting the personnels and
the pateints by acting as a barrier material from the microbial penetration
in the air and in liquids. But then again there are several requirements for
the material and processes used to manufacture a nearly ideal surgical
gown. Besides just providing the barrier against contaminants, it must
provide the wearer sufficient comfort that keep them at a normal stress
level so they can work at their best.

ANALYSIS OF DEMANDS FOR COMFORT/DISCOMFORT:

Cotton textiles or conventional mixed cotton-polyester textiles, the
traditional materials for surgical gowns and drapes, meet a number of
requirements, such as comfort, drapeability, good tensile strength, steam
permeability and steam sterilisability. However, they will not meet the
requirements of the new standard which includes resistance to microbial
penetration, resistance to liquid penetration and minimal release of
particles.

PROPERTIES:

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Among the basic requirements of providing the contamination and fluid

barrier, there are several other characteristics that are needed in a
surgical gown. Other requirements include aesthetics (comfort,
conformability and softness) as it may affect the perspiration and
movement, fiber tie down properties (linting and abraission resistance)
because the particles from gown may complicate the wound healing
process, flame and electrostatic resistance; especially for laser
applications and when administrating oxygen because of the danger of
explosion, drapeability, and strength requirements include tensile, tear,
burst and puncture resistance.
Resistance to microbial
penetration – dry
Resistance to microbial
penetration – wet
Cleanliness – microbial
Cleanliness – particulate matter
Linting
Resisting to liquid penetration
Bursting strength – dry
Bursting strength – wet
Tensile strength – dry
Tensile strength – wet
General performance requirements of a surgical gown established by CEN.

SOLUTION:
Most of the medical protective clothing currently in the USA, may be as
much as 80%, is made from nonwoven materials and used only once.
The outer surface of nonwoven is treated with fluorocarbon for liquid
repellency. The nonwoven is laminated to a waterproof film in situations
where a total barrier is required, and in some cases waterproof breathable
films such as Gore-Tex are used. There is a wide variety of non-wovens of
all types including hydroentangled, bonded, stitched, and laminated, of a
range of quality depending on the intended use by the manufacturer;
spunbonding and combination of spunbond/meltblown non-wovens are
probably the most commonly used technique in manufacturing of surgical

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Clothing physiology of surgery room

gown. Its because spunbonding gives the required strength and the
densely-packed meltblown layer between the spunbonded fibers provide a
barrier to blood, body fluids and pathogens.
In the UK and Europe, protective clothing are reusable and are produced
from tightly woven cotton and polyester/cotton fabrics which are
laundered at high temperatures (e.g., 74oC), and sterilized [72].

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SPECIFIC NEW COMFORT MATERIALS AND PROPERTIES:

A good material for surgical gown will be the one that provide ideal barrier
against infectious contaminations and provide comfort for longer period of
times and is of low cost. The ideal barrier fabric would be sterilizable, and
resistant to blood and viral penetration; while a breathable, lightweeight
and flexible fabric material would be ideal for providing comfort to the
wearer.
Thanks to the new technological advances in fabric materials and
manufacturing processes that we can combine them to get a nearly ideal
fabric to achieve both, ideal barrier performance and good physiological
comfort. Some of the newer materials are discussed below.
MEDLINE INDUSTRIES INC.:
Medline is one of the largest medical-surgical
textiles manufacturer. They have made use of
DuPonttm Softese® and Suprel® fabrics in their
surgical gowns Eclipse® and Aurora® respecively,
along with these smart fabrics, they have made
changes to commonly available SMS(spunbonded-meltblown-spunbonded)
SMS layer as seen under
microscope
surgical gowns to make it more resistant to bacterial penetration. This
gown falls in their Sirus® surgical gown line and it uses SMMS(spunbond-2
x meltblown-spnbond) technique for added resistance. The DuPonttm
Softese® and Suprel® fabrics will be discussed in more detail under
DuPonttm heading.
DUPONTTM:
Suprel®: Suprel medical fabric is based on DuPont’s new
Nonwovens Advanced Composite technology. This
bicomponent fabric is made of polyester (for strength) and
polyethylene (for comfort). This fabric design provides a high
level of comfort without compromising the protection barrier against fluids
and other bacterial contaminants. More than 20 patents have been filed
for this fabric so far regarding its manfacturing process and its advance
composite technology (ACT). This fabric is available in market through
Medline and others.

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Softesse®: Softesse medical fabric is made mainly for

providing comfort to OR personnels who spend long hours. It
is spunlaced fabric, soft to the touch with advanced material
technology that provides acceptable barrier protection
against liquid penetration. Plus, it keeps the wearer cool, fresh and
comfortable in the OR while working for 20 hour and coping with the
stress, which is a common stuation for OR personels.
All of the DuPont medical fabrics comply with the EN13795 standard
established by European Committee for standardization (Comité Européen
de Normalisation or CEN).
AHLSTROM CORPORATION:
Ahlstrom is a global leader in the development, manufacture
and marketing of high performance fiber-based materials.
Among several other products, Ahlstrom also offer their
trademark BVB (Breathable Viral Barrier) surgical gowns.
BVBtm fabric is a tri-laminate polypropylene based composite material with
a breathable monolithic (seamless) film. It is strong with good softness,
high breathability, and provides excellent barrier properties against real
world viruses causing infectious diseases such as HIV/AIDS, SARS, Avian
Influenza and H1N1.
SRI SURGICAL:
They make use of Gore® Teflon membranes to manufacture reuseable
surgical gowns that are manufactured from 100% polyester filament
making it vrtually lint free, as an effort to minimize environmental
damage. Gore membrane technoogy for surgical gown is discussed below.
W.L. GORE & ASSOCIATES:
Gore™ Membranes: incorporate expanded PTFE (ePTFE) membrane
technology along with other uses is also used for contamination barrier.
Unlike non-expended form of PTFE, ePTFE exhibits high porosity and
tensile strength and is extremely hydrophobic, which means highly
breathable and strong mcrobial barrier.
ALLEGIANCE SMARTGOWN:

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Allegiance, McGaw Park, Illinois, USA has developed disposable surgical

drapes and gowns. The nonwoven, multi-ply laminates exhibit desirable
softness, foldability, absorbency, and breathability characteristics. The film
layers and nonwoven web layers are secured together by spaced-apart
adhesive clusters. The breathable, impervious film layer is, preferably, a
monolithic thermoplastic copolyester elastomer film with a basis weight of
10–170 g/m2 and a thickness of 0.25–3.0 mm. The web is made of
thermoplastic fibers, regenerated fibers, natural fibers, or bicomponent
fibers. The adhesive can be a thermoplastic adhesive, a thermosetting
adhesive, or a cross-linked adhesive that can withstand gamma
sterilization.
Reference:
[1] M.J. Abreu, Designing surgical clothing and drapes according to the
new technical standards, International Journal of Clothing Science and
Technology (2003).
[2] Eric C. Wigner and Keith Fritsky, Use of expanded PTFE membranes in
medical filtration, Journal of Medical design technology (2009).
[3] Adanur, S., Wellington Sears Handbook, Technomic Publishing, USA,
(1995).
[4] Fung, W. Products from Coated and Laminated Fabrics, In: Coated and
Laminated Textiles, The Textile Institute, Woodhead Publishing Ltd,
Cambridge, England, (2002).
[5] Anonymous. Intermittently Bonded Laminates, Medical-Textiles, March:
4–5, (2004).
[6] Anonymous. Viral Barrier offer Optimum Comfort for Medical Gowns,
Medical Textiles, January: 2–3, (2005).
[7] http://www.ahlstrom.com ( for BVB fabric)
[8] http://www.medline.com (for Aurora, Eclipse and Sirus surgical gown)
[9] http://www.gore.com (for Gore membrane and gore surgical fabric)
[10] http://www.srisurgical.com (for reuseable Gore LP surgical gowns)
[11] http://medicalfabrics.dupont.com (for Softesse and Suprel medical
fabrics)
[12] http://www.cardinal.com (for smart gown)

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[13] http://64.239.127.20/clients/cardinal/SmartGown_640x480.mov
(technology video)