FACTORS THAT INFLUENCE THE EFFECTIVENESS OF SURGICAL GOWNS IN THE OPERATING-THEATER

Objective: To compare the barrier function, comfort, and protection af forded by nine types of surgical gowns during use and to identify fact ors that may influence their effectiveness. Design: Prospective random ised study. Setting: Teaching hospital, Greece. Material: 4 Types of d isposable single layer gowns, 1 reusable cloth gown, and 4 types of di sposable reinforced gowns used during 250 major operations by the surg eon and first assistant (total n = 500). Interventions: Direct observa tion by specially trained nurse and questionnaire to surgeons. Main ou tcome measures: Contamination of the outside of the gown, blood strike through, safety, and comfort. Results: Half of all gowns became conta minated on the outside. The mean total rate of strike through was 90% in reusable gowns (528/586 areas contaminated), 11% in disposable sing le layer gowns (95/855 areas contaminated), and 3% in disposable reinf orced. gowns (42/1407 areas contaminated). There were differences in s trike through among the disposable gowns depending on the material and design, the reinforced gowns consistently showing less strike through than the single layer ones. The areas most vulnerable to strike throu gh were the cuff, forearm, thigh, chest, and abdomen. From 80% to 99% of surgeons felt comfortable and protected wearing disposable gowns, b ut only 0 to 4% of surgeons felt comfortable and safe with reusable go wns. Conclusions: Reusable cloth gowns have a high strike through rate and were rejected by most surgeons. Reinforced disposable gowns provi ded better protection. The highest strike through was at the cuffs, fo rearms, and thighs, and this requires new designs for surgical gowns.