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The Origin And Development of The Surgical Gown

Dec. 17, 2019

The upgrade of surgical gown protection was proposed by William et al. in 1952. Although the cotton material medical gown can block a certain amount of microorganisms in the dry state, in the bloody or wet state, the pathogen will penetrate the surgical gown through the liquid. The surgical gown is therefore completely unprotected. He proposed to develop multi-layer fabrics as a material for surgical gown, providing multiple protections for surgeons and patients, but it has not fundamentally rid of the problem of easy defoliation of cotton and the penetration of microorganisms through layers of moist cloth. On the other hand, with the development of the non-woven fabric industry in the 1950s, the disposable surgical gown of non-woven fabrics quickly occupied a part of the market due to their excellent dry and wet protection and material strength.


In the 1980s, the immunodeficiency syndrome (AIDS) was recognized, and its highly contagious virus (HIV) was rampant in the world. The protection of special populations working in the front line has received more and more attention from the society. According to reports in the literature, 4.2% of serum HIV antibodies were positive among medical personnel who had been exposed to HIV blood in the United States. It can be seen that the adoption of strict protective measures for medical personnel has become an urgent public health problem. During the operation, it is found that the increase of environmental particulate matter will increase the probability of postoperative complications, prolong the hospitalization time, increase the cost of treatment, and even threaten the life of the patient. The environmental particulate matter is mainly derived from the batt or off-line of the surgical gown, and the dust transmitted from the air-conditioning ventilation equipment. These particulate matter become the carrier of the pathogen, and once it falls into the wound, it is easy to cause allergies and infections. Therefore, in the 1990s, European and American countries required higher strength materials for surgical gowns and surgical orders.


After several decades of development, disposable surgical gown began to occupy the US surgical gown market with high protection and material strength; in the early 21st century, the ratio of disposable surgical gown in the US surgical gown market was >70%, Europe Also reached nearly 30%. However, in recent years, European and American countries have begun to realize that disposable surgical gowns have a certain burden on the environment compared to recyclable medical gowns. According to statistics, medical waste accounts for 2% of all urban waste in the United States, while disposable surgical gowns and surgical orders account for 0.04% of all municipal waste. A large amount of waste and high cost of use have led US hospitals to reconsider the use of reusable surgeon gowns that are more economical and have a protective effect that is even better than disposable surgical gowns.


There are two main types of materials for reusable surgical gowns: the first is a single-layer high-density woven fabric, such as the Compel fabric developed by Standard Textile in 1988, which has good water and oil resistance. In 1991 and 1992, Ashley Woodcock Company of the United States and Burlington Company of the United States successively developed the use of polyurethane for coating finishing, which made the fabrics have liquid-repellent and antibacterial properties. In 1993, Dover Company of the United States made the fabric waterproof by applying a waterproof film on a layer of fabric base fabric. In 1994, Klopman Company of the United Kingdom made anti-wrinkle and anti-liquid treatment of polyester-cotton blended yarn, which made the fabric have anti-blood and washing-resisting properties. In general, the fabrics are mainly loaded with a waterproof coating on high-density woven fabrics, but in a medical washing environment such as high temperature and high pressure, disinfectant, etc., after 20 to 30 times of sterilization, the coating gradually peels off. As a result, the waterproofness is continuously attenuated, and once the waterproof property is lost, the surgical gown will completely lose its protective effect. On the other hand, liquid sputtering may suddenly occur during the operation, even if the single-layer fabric that has just been loaded with the waterproof coating cannot withstand the penetration of the liquid because its water pressure resistance cannot reach the level of the composite material. Therefore, according to the degree of protection required by the US operating room, single-layer high-density fabrics are generally only suitable for surgical operations with a small amount of bleeding or fluid. The second high protective material is a multilayer composite fabric. For example, the product reported in U.S. Patent No. 5002070 in 1991 uses two layers of polyester cotton fabric, wherein the surface layer is waterproof. However, as with the single-layer fabric, once the surface waterproof layer is applied off, the protective properties will disappear. Gore has developed a medical film that is sandwiched between two layers of waterproof polyester material. Even if the surface material loses water resistance, the intermediate medical film itself has a small pore size, which is sufficient to prevent water and bacteria. More and more European and American companies have begun to develop new composite membranes for the production and production of surgical gowns, including PE, PU, TPU, PTFE and so on. The inner and outer layers of the composite membrane material structure are general fabrics or fabrics with functions of waterproofing, antistatic, anti-floating and pilling, and the intermediate layer is adhered by a medical film, which can effectively block the penetration of blood, bacteria and even viruses. The water vapor in the skin of the person can also pass through the medical film to ensure the physiological comfort of wearing.

Taking a PTFE membrane as an example, there are 9 billion micropores with a diameter of about 0.5 pm on a film per square inch (ie, an intermediate layer of a three-layer laminate). The diameter of one drop of water is 20,000 times larger than that of the water droplet. The film is passed through, but each pore is 700 times larger than the diameter of the water vapor molecule, so that the water vapor evaporated by the human sweat can penetrate the film well. The textile material on the surface of the surgical gown can be selected from polyester materials, which is higher than the cotton surgical gown in strength and toughness, as well as the number of washable and service life. If the correct washing method is used, it can usually be repeated more than 100 times.

In addition, other literatures have shown that other polymeric membrane materials can also transfer sweat to the outside through the long-chain end-absorbing group, thereby achieving a comfortable wearing effect.


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