COMPARISON OF GOWNS/COVERALLS
- Disposable isolation gowns, disposable protective gown and disposable surgical gown are all personal protective equipment commonly used in hospitals. However, during the clinical supervision process, we often find that medical staff are a bit confused about these three. Now let’s talk about the similarities and differences between the three parties from the following aspects.
- First, the function
- Disposable Isolation gowns : A protective article used by medical personnel to avoid exposure to blood, body fluids, and other infectious materials, or to protect patients from infection. The gown is a two-way isolation that prevents both medical personnel from being infected or contaminated and prevents the patient from being infected.
- Disposable Protective gown: Disposable protective equipment worn by clinical staff when exposed to Class A or infectious disease patients managed by Class A infectious diseases. Protective clothing is to prevent medical personnel from being infected and is a single isolation.
- Disposable Surgical Gown: The surgical gown plays a two-way protective role during the operation. First, the surgical gown establishes a barrier between the patient and the medical staff to reduce the probability of medical personnel contacting the patient’s blood or other body fluids during the surgical procedure. Second, the surgical gown can block the colonization/adhesion of the medical staff’s skin or clothing. Various bacteria on the surface are transmitted to surgical patients, effectively avoiding cross-infection of multi-drug resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Therefore, the barrier function of surgical gowns is considered to be the key to reducing the risk of infection during surgery.
- Second, dressing indications
- Disposable Isolation gowns: 1. Patients exposed to contact-borne infectious diseases such as multi-drug resistant bacteria. 2, when the patient is protected from isolation, such as large-area burn patients, bone graft patients with diagnosis and treatment, care. 3, may be affected by the patient’s blood, body fluids, secretions, discharges splashing. 4. If you want to enter the key departments such as ICU, NICU, protective ward, etc., whether you need to wear a gown, you should decide on the medical personnel to enter the purpose and contact with the patient.
- Disposable protective gown: 1. When exposed to a class A or a patient managed by a Class A infectious disease. 2. Follow the latest infection control guidelines when contacting patients with suspected or confirmed SARS, Ebola, MERS, H7N9 avian influenza.
- Disposable surgical gown: used in strict sterile sterilization and invasive treatment of patients in specialized operating rooms.
- Third, appearance and material requirements
- Disposable isolation gowns: Disposable surgical gown are usually made of non-woven materials or combined with materials that have better barrier properties, such as plastic film. The integrity and toughness are achieved through the use of various nonwoven fiber joining techniques rather than the geometric interlocking of woven and knitted materials. The gown should cover the torso and all the clothes to form a physical barrier for the spread of microorganisms and other substances. It should have impermeability, abrasion resistance and tear resistance. There is no specific standard at present, there is a brief introduction to the wear and tear of the gown (the gown should be open at the back to cover all the clothes and exposed skin), but there are no relevant indicators such as specifications and materials. The gown can be re-used or disposable, without a hat. From the definition of the gown, there is no requirement for anti-penetration, and the gown can be waterproof or non-waterproof.
- Disposable protective gown: Protective gown consists of hooded tops and trousers. Can be divided into a one-piece structure and a separate structure. The trouser legs and cuffs are tightened, and the protective clothing has a higher degree of protection than the gown. It is generally recommended to use one-off.
- The standard clearly states that protective gown must have liquid barrier function (water resistance, moisture permeability, anti-synthetic blood permeability, surface moisture resistance), flame retardancy and antistatic properties, for breaking strength, elongation at break, filtration Efficiency and other requirements are required.
- Disposable surgical gown: According to the European standard EN13795, surgical clothes materials have clear requirements for barrier properties, strength, microbial penetration, and comfort. The surgical gown should be impervious, sterile, conjoined, and without a hat. Generally, the cuffs of the surgical gown are elastic and easy to wear, which is good for wearing sterile gloves. It is not only used to protect medical personnel from infectious substances, but also to protect the sterility of surgically exposed parts.
- In summary, in terms of appearance, protective gown is well distinguished from isolation gown and surgical gown. Surgical gowns are not well differentiated, and can be distinguished according to the length of the belt (the girth of the gown is tied to the front and is easy to take off. The belt of the surgical gown is attached to the back). The functions of the three have intersecting places. The requirements for disposable surgical gowns and protective gown are significantly higher than disposable gowns. In the case of clinically common use of gowns (such as contact isolation of multi-drug resistant bacteria), disposable surgical gown can be interlinked, but places where disposable surgical gowns must be used cannot be replaced by gowns. From the point of view of the process of wearing and taking off, there are several differences between the isolation gown and the surgical gown:
- (1) the cleaning garment is protected from contamination when the garment is worn and worn, while the surgical garment is more focused on aseptic operation; (2) the isolation garment can be Single person finishes, and the surgical gown must be assisted by the assistant;
- (3) The gown can be used repeatedly without pollution. After use, it is hung in the corresponding area, and the surgical gown must be cleaned, sterilized, and used after being worn once. The disposable protective gown is commonly used in the microbiology laboratory, infectious disease negative pressure ward, Ebola, avian flu, mers and other epidemic situations to protect medical personnel from pathogens.
- The use of the three is an important measure for the prevention and control of infections in hospitals, and plays an important role in protecting patients and medical workers.
- Isolation gown
- Wear isolation gown:
- (1) The right hand collar, the left hand into the sleeve, the right hand pulls the collar up to reveal the left hand.
- (2) Change the left hand collar, the right hand into the sleeve, reveal the right hand, raise your hands and shake the sleeves, be careful not to touch the face.
- (3) Two hand-held collars, with the neckband extending backwards from the center of the collar to the back.
- (4) Pull the isolation garment on one side (about 5 cm below the waist) and see the edge pinch. The same method is used to pinch the other side edge.
- (5) Align the sides of the clothes with your hands behind.
- (6) Fold to one side, hold the fold with one hand, and pull the belt to the back fold with the other hand.
- (7) Cross the belt at the back and return to the front to tie the belt.
- Detachment Method :
- (1) Untie the belt and hit a knot in front.
- (2) Disinfect the hands.
- (3) Untie the back of the neck.
- (4) The double-hand strap pulls the gown from the chest.
- (5) Hold the left collar on the inside of the left collar and remove the left sleeve.
- (6) Hold the right side of the collar on the right side and pull off the right sleeve. The coat will be contaminated and the collar and the side of the garment will be rolled to the center and placed in the designated container.
- 2. Protective gown
- Wear protective gown method: conjoined or split body protective gown, should follow the first to put on the clothes, then put on the jacket, then put on the hat, finally pull the zip sequence.
- Method of taking off protective gown:
- (1) split body protective gown:
- 1) the zipper should be unzipped first.
- 2) lift the hat up to remove the head from the hat.
- 3) take off the sleeves and put the contamination face inside the designated container.
- 4) remove the contamination of the lower garment from the top to the bottom, and put it into the designated container.
- (2) One-piece protective gown
- 1) pull the zipper down first.
- 2) lift the hat up to remove the head from the hat.
- 3) take off the sleeves and roll the edges from the top down.
- 4) remove and put into the designated container.
- 3. Surgical gown
- Wearing a surgical gown method:
- (1) Take out a piece of sterile surgical gown from the opened sterile bag, look for the collar, lift the two corners of the collar with both hands, and shake the room in a more spacious place (with a barrier of 1.5 meters in front). Open the surgical gown and take care not to point the outside of the surgical gown to yourself.
- (2) Put the surgical gown away from the air and insert your hands into the sleeve quickly.
- (3) The two arms are lifted straight forward, and the patrolling nurse assists the slings in the back and fastens them, and the hands reach out of the cuffs.
- (4) The body leans forward, lifts the belt, hands crossed, and the patrolling nurse takes the belt behind the back and fastens it.
- Undressing method
- (1) After the aseptic operation is completed, if another operation is needed, such as the glove is not broken, you do not need to brush your hands again. You only need to soak the alcohol or benzalkonium bromide solution for 5 minutes. You can also use iokang or sterilized king. Apply your hands and forearms, then wear sterile surgical gowns and gloves.
- (2) If the previous operation is a contaminated operation, the hands should be washed again before surgery, and then sterile surgical gowns and gloves are worn.
- (3) Only one operation can be assisted by the visiting nurse to untie the belt and remove the surgical gown and gloves.
Testing
- The Association for the Advancement of Medical Instrumentation (AAMI) standards are designed to help medical-device companies meet global standards for the safe use of medical devices. AAMI introduced the voluntary standard ANSI/AAMI PB70:2012, Liquid Barrier Performance and Classification of Protective Apparel and Drapes Intended for Use in Health Care Facilities, to determine key identification measures for the appropriate selection of protective apparel and drapes, such as medical gowns, for use in healthcare facilities (Pfiedler Enterprises, 2016). The AAMI gown classification stems from four levels of barrier performance, measured accordingly with the following standardised tests:
- AATCC 42-2017: Measures resistance of fabrics to the penetration of water by impact (AATCC, 2018)
- AATCC 127-2017: Measures resistance of fabric to the penetration of water under hydrostatic pressure (AATCC, 2017)
- ASTM F1670-17: Evaluate resistance of materials used in protective clothing to penetration by synthetic blood under conditions of continuous liquid contact (ASTM, 2017)
- ASTM F1671-13: Measure penetration by blood-borne pathogens using a surrogate microbe under conditions of continuous liquid contact (ASTM, 2013).
BARRIER PERFORMANCE BARRIER PROTECTION RESISTANCE MEASURES TEST TEST CRITERIA ACCEPTABLE QUALITY LEVEL Level 1 Minimal Liquid Penetration AATCC42 Water Impact ≤ 4.5g 4% Level 2 Low Liquid Penetration AATCC42
AATCC127
Spray Impact ≤ 1.0g
Hydrostatic Pressure ≥ 20cm
4%
4%
Level 3 Moderate Liquid Penetration AATCC42
AATCC127
Spray Impact ≤ 1.0g
Hydrostatic Pressure ≥ 50cm
4%
4%
Level 4 High Liquid and Viral Penetration ASTM F1671 Pass 4% AAMI Levels
Defining the best level of protection for the standard ANSI/AAMI PB70:2012 involves an understanding of the critical zones of a gown and what each level of barrier performance entails, so that the best gown is chosen for use by healthcare workers.
The critical zones of gowns comprise of the front of the gown and the sleeves, which are both primary areas with the greatest risk of exposure to fluids and blood-borne pathogens. As the level increases, so does the need for greater barrier protection for the entire critical zone.
- Level 1: Minimal level of fluid barrier protection
- Level 2: Low level of fluid barrier protection
- Level 3: Moderate level of fluid barrier protection
- Level 4: Highest level of fluid and viral barrier protection