clothing physiology

Smarta Textilier och Högteknologiska KläderSmart Textiles and High-Tech Clothing

Clothing Physiology of Surgery room

Ubaid ur Rehman Eusuf [email protected]

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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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)

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.5

SMS layer as seen under microscope


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)

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