An investigation of occlusive polyester surgical clothing

doi:10.1016/0195-6701(90)90093-4

Journal of Hospital Infection

Volume 15, Issue 4, May 1990, Pages 363-374

https://doi.org/10.1016/0195-6701(90)90093-4 Get rights and content

Abstract

The bacterial dispersion rate of people wearing operating room clothing made from several types of polyester fabric was compared to conventional cotton clothing, total-body exhaust gowns and disposable clothing. Airborne bacteria were measured in a chamber, three ultra-clean air operating rooms and a conventionally ventilated operating room. The polyester clothing was demonstrated to be much superior to conventional cotton clothing and at least as good as the total-body exhaust gowns and disposable clothing.

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Cited by (32)

Comparison of number of airborne bacteria in operating rooms with turbulent mixing ventilation and unidirectional airflow when using reusable scrub suits and single-use scrub suits
2023, Journal of Hospital Infection
A low count of airborne bacteria in the operating room is a means to prevent surgical site infection.
To investigate levels of airborne bacteria during surgical procedures in two operating rooms with turbulent mixing ventilation (TMV) and unidirectional airflow (UDAF), both with an air supply of 2600 L/s, when staff used either reusable scrub suits made from a mixed material (dry penetration ≤300 cfu) or single-use scrub suits made from polypropylene (dry penetration ≤100 cfu).
In the TMV-room cfu/m³ air was measured during eight procedures with staff wearing reusable scrub suits and seven procedures with single-use scrub. In the UDAF-room cfu/m³ air was measured during seven procedures with staff wearing reusable scrub suits.
Mean values of cfu/m³ air were 1.3–10.8 in the TMV-room with staff dressed in reusable scrub suits and 0.8–4.0 with staff dressed in single-use scrub suits (P<0.01). Mean values of cfu/m³ air were 0.2–4.5 in the UDAF-room with staff dressed in reusable scrub suits. The difference obtained with reusable scrub suits in the two rooms was significant (P<0.01).
The mode of ventilation affects the cfu levels when staff are dressed in less occlusive scrub suits despite a high air supply. It is possible to decrease the cfu levels in a TMV-room by using scrub suits made from a tight material, thus reaching the same levels that are achieved by less protective scrub suits in a UDAF-room.
Effect of using ceiling-mounted systems for imaging in hybrid operating rooms on the level of colony-forming units during surgery
2019, Journal of Hospital Infection
Citation Excerpt :
A substantial number of these factors relate to air quality and might affect the incidence of SSI through airborne contamination. They include staff behaviour and discipline, cleanliness of the operating room environment, presence of equipment with moving parts or other objects in the operating room, and the type and dimensions of the ventilation system [unidirectional flow (UDF) system or other] [2–18]. HORs usually have large dimensions (70–80 m2 is common in the Netherlands) to ensure effective use.
Large imaging systems in hybrid operating rooms are used increasingly. However, the effect of these ceiling-mounted imaging systems on air quality during surgical procedures has not been studied to date.
To evaluate the level of colony-forming units (cfu)/m³ near the surgical wound and near the instrument table during surgery.
Measurements were performed in four hybrid operating rooms at four different hospitals. During surgical procedures, at least three samples were taken with active slit air samplers. At the end of the day's surgical schedule, simulations involving movement of the ceiling-mounted system were also performed. The threshold value for the average cfu level during a surgical procedure was set at ≤10 cfu/m³, and for individual samples was set at ≤30 cfu/m³.
The median value near the surgical wound was 1 cfu/m³ and at the instrument table was 2 cfu/m³. However, in one hybrid operating room (two procedures out of 16) where the instrument table was not positioned directly under the unidirectional flow (UDF) system, the threshold value for the average cfu level at the instrument table was exceeded. For one of these procedures, the maximum value for an individual sample was also exceeded.
A ceiling-mounted imaging system in combination with a UDF system can result in cfu levels near the surgical wound and at the instrument table that are well below the threshold value of 10 cfu/m³ during surgery. If the instrument table is not positioned directly under the UDF system, the cfu level is higher.
General Assembly, Prevention, Operating Room - Surgical Attire: Proceedings of International Consensus on Orthopedic Infections
2019, Journal of Arthroplasty
Comparison of two single-use scrub suits in terms of effect on air-borne bacteria in the operating room
2017, Journal of Hospital Infection
Citation Excerpt :
This can be achieved by a ventilation system that dilutes and/or sweeps away the bacteria-carrying particles in the air,1 or by the prevention of shedding of bacteria-carrying skin scales by staff in the operating room by wearing total-body exhaust gowns or scrubs made from low-permeability material.4 Several studies have investigated the protective capacity of scrubs made from re-usable materials, mainly polyester and mixed materials (cotton/polyester).5,6 Two previous studies have shown that single-use scrubs made of polypropylene resulted in lower counts of colony-forming units (cfu) in the operating room air than scrubs made of re-usable materials.7,8
A low level of air-borne bacteria in the operating room air can be achieved if all staff wear clothes made of low-permeability material (i.e. clean air suits). This study investigated if there was a difference in protective efficacy between two single-use scrubs made of polypropylene by testing them during routinely performed orthopaedic surgical procedures. No significant difference in the colony-forming unit count/m³ air was found between the two scrubs, so the choice can be based on which scrub type is more comfortable for staff.
Numerical simulation of the impact of surgeon posture on airborne particle distribution in a turbulent mixing operating theatre
2016, Building and Environment
Citation Excerpt :
In a patient care room, Zhao et al. [31] examined different posture and gestures of the nurse and found that BCPs that emitted from a standing nurse may rarely reach the patient, although those BCPs can easily reach the patient when the nurse is bending over the patient. Whyte et al. [32] compared the performance of polyester fabric clothing with total-body exhaust gowns, disposable and conventional cotton clothing. They conclude that the polyester clothing was much superior to conventional cotton clothing, and almost the same as both disposable clothing and the total-body exhaust gowns.
Airborne particles released from surgical team members are major sources of surgical site infections. To reduce the risk of such infections, ultraclean-zoned ventilation systems have been widely applied, as a complement to the ventilation of the main operating theatre. The function of ventilation in an operating theatre is usually determined without considering the influence of the staff members' posture and movements. The question of whether the surgeon's posture during an on-going operation will influence particle distribution within the surgical area has not yet been explored in depth or well documented.
In the present study we analysed data from investigation of two positions (bending and straightened up), which represent the most common surgeon and staff-member postures. The investigation was performed by applying the computational fluid dynamics methodology to solve the governing equations for airflow and airborne particle dispersion. Ultraclean-zoned ventilation systems were examined as an addition to the conventional operating theatre. We examined three distinct source strengths (mean value of pathogens emitted from one person per second) due to the variety of staff clothing systems.
In the upright posture, the screen units reduced the mean air counts of bacteria and the mean counts of sedimenting bacteria to a standard level for infection-prone surgeries in the surgical area. However, the performance of this system could be reduced drastically by improper work experience. Surgical garments with a high protective capacity result in lower source strength and thus reduces the particle concentration within the surgical area. These results are useful for developing best practices to prevent or at least reduce the infection rate during a surgical intervention.
Clinical issues-September 2013
2013, AORN Journal
Requirements for immediate use steam sterilization (IUSS)
Key words: immediate use steam sterilization, IUSS.
Gravity-displacement and dynamic air-removal cycles for steam sterilizers located outside of the sterile processing area
Key words: gravity displacement, dynamic air removal, flash cycles, immediate use steam sterilization, IUSS.
Terminal sterilization using steam sterilizers located outside of the sterile processing area
Key words: terminal sterilization, physical monitors, chemical indicators, biological indicators.
Physical, chemical, and biological monitoring tools for steam sterilizers located outside of the sterile processing area and used for immediate use steam sterilization (IUSS)
Key words: physical monitors, chemical indicators, biological indicators, gravity displacement, dynamic air removal.
Unscrubbed personnel wearing long-sleeved jackets
Key words: long-sleeved jackets, recommended practices, skin squames, preoperative skin antisepsis, skin prep.
Unscrubbed personnel wearing blankets over surgical attire
Key words: blankets, low-linting, surgical attire, skin squames, trips and falls, professional appearance.

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Original articleAn investigation of occlusive polyester surgical clothing

Abstract

Lancet

Dispersal of non-spore forming anaerobic bacteria from the skin

Journal of Hygiene (Cambridge)

Attempt to control clothes-borne infection in a burns unit. I. Experimental investigations of some clothes for barrier nursing

Journal of Hygiene (Cambridge)

Influences of fabric construction on the performance of clean room garments

Ultraclean air and antibiotics for prevention of postoperative infection

Acta Orthopaedica Scandinavica

Original article
An investigation of occlusive polyester surgical clothing