Surgical Gown: Applications & Health Benefits

The surgical gown is classified under the generic term “area clothing.” As a medical device, it is responsible for preventing or minimizing the spread of pathogens in the surgical wound area. The goal is to prevent post-operative wound infection.

What is a surgical gown?

As a medical device, the surgical gown is responsible for preventing the spread of pathogens in the surgical wound area. The European series of standards DIN EN 13795 defines the requirements for medical products. The surgical gown must be sterile and form an effective germ barrier. It has defined functional and mechanical properties and its design and material are such that particle emission is reduced to a minimum. In this respect, the 8th GPSGV and BGR 189 for protective clothing must also be observed. If surgical gowns are worn in operating areas where there is a risk of exposure to pathogens or infection, they must have additional labeling in accordance with the 8th GPSGV in order to be classified as “PPE”, “personal protective clothing”. The manufacturers and the BGR 189 rule provide information on this point.

Forms, types and types

Two material classes of surgical textiles exist: liquid-tight (high performance) and exciter-tight (standard performance). There are disposable and reusable gowns. A synonym is surgical gown, because the surgical gown does not only protect the chest, abdomen and leg area like an ordinary household gown, but also includes the arms with cuffs and reaches to the neck like a gown. There are wraparound gowns, slip-on gowns and gowns that are tied at the back. Most surgical gowns are made of spunlace, a fabric-like, sterilizable viscose material. Depending on the application, they come in various shapes, sizes, materials and colors. Sterilizable textiles made of 100 percent cotton are also used. The main colors are green, blue and white. These different colors certainly have their significance. For rounds in hospitals or doctors’ offices, doctors wear white work clothes consisting of trousers, a top and a gown. In the infection-sensitive surgical areas, green or blue area clothing is used. Clinics establish a restrictive dress code for all areas that determines what clothing is to be worn in which rooms. Green area clothing is worn by physicians when performing infection-sensitive surgeries, while the blue color is mostly used for all other procedures. This also allows hospital visitors and patients to distinguish surgeons working in the surgical areas from colleagues working outside these infection-sensitive areas. The different colored area clothing helps medical staff to notice these differences immediately and to implement hygienic regulations in the best possible way. Doctors must remove their green area clothing within the operating rooms before leaving this sensitive area in order not to transfer germs and other carriers of disease to the premises and patients, which are less demanding in this respect. Otherwise, if this dress code is not followed, physicians can introduce microbes when they return to the operating rooms. The different colors have other meanings as well. Hospital logistics are simplified because the flow of laundry can be better managed. The cleaning staff can immediately recognize which clothes are involved and sort them accordingly. Area clothing from the operating theaters requires higher cleaning standards than white clothing that doctors only wear during rounds. Visual points are also taken into account. White scrubs reflect the bright and artificial light from OR lights and can cause eye fatigue or glare. Green scrubs are harmless in this regard. Also, green textiles have a calming effect and prevent the afterimage effect that always occurs when a doctor looks at a red wound for a long time and his gaze then falls on white textiles. This problem hardly occurs with green and blue textiles. Consideration is also given to the patient’s psyche. Bloodstains on a white background appear much more threatening than on green or blue textiles.

Structure and mode of operation

Colored surgical gowns facilitate visual perception. This is why most surgical gowns are green. The OR is a protection level 2 area (TRBA 250) and may only be entered by authorized personnel.First and foremost, the surgical gown serves to control fluids and is to be emphasized from a hygienic point of view. In medical activities where there is an increased risk of transmissible diseases from body fluids and blood, the surgical gown prevents contamination of medical personnel with pathogens. No high demands are made on the absorbency, unless endoscopic procedures are involved, which register a high proportion of fluids. Surgical clothing prevents direct contact of the skin and body surface of medical personnel with wounds, blood and body fluids of patients. Patient protection takes precedence over the environmental aspects of reprocessing. Several studies have proven that there is no difference between disposable and reusable textiles in terms of life cycle assessment. However, they must not contain harmful ingredients such as endotoxins or heavy metals that make disposal difficult.

Medical and health benefits

The surgical gown in its current form has not been around long. As early as 1952, American physician William C. Beckbereits called for liquid-repellent surgical gowns in all clinical settings because liquids promote the spread of pathogens. Today, surgical gowns are used for single and multiple uses. Today’s “gold standard” is liquid-repellent and liquid-tight up to a certain material thickness. The previously cited European directive defines the properties that surgical textiles, which include surgical gowns, must have in order to be classified as medical devices. They must have microbiological purity (bioburden), be repellent to particulate material (foreign material), release particles on the surface, be resistant to liquid penetration, be tear and burst resistant when wet and dry, and be comfortable to wear. The surgical gown is ergonomic and allows adequate freedom of movement. Surgical area gowns are put on over undergarments after changing in the surgical sluice and are worn only within the surgical area.