Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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1 A level field. Surgical gowns were once marketed primarily through such descriptive but non-specific claims as "fluid resistant," "prevents strikethrough" and "impermeable." In 2003, however, a consensus standard from the Association for the Advancement of Medical Instrumentation and the American National Standards Institute established uniform testing methods for manu- facturers to objectively rate their gowns' protection characteristics. The AAMI/ANSI PB70 standard, "Liquid Barrier Performance and Classification of Protective Apparel and Drapes Intended for Use in Health Care Facilities," was recognized by the U.S. Food and Drug Administration the next year. Gowns classified as Level 1 or 2 offer minimal or low barrier protection, while Level 3 or 4 gowns provide moderate or high barrier protection. 2 Testing 1, 2, 3, 4. A gown's level is determined through its performance in the following tests: • Water resistance: impact penetration assesses how fibers, yarns and textile con- struction stand up to a 1-pound-per-square-inch (psi) water spray. A lower num- ber represents higher repellency. All 4 levels meet acceptable quality scores. • Water resistance: hydrostatic pressure pits gown fabric against a stream of water. A higher number represents greater resistance to penetration. Level 2, 3 and 4 gowns pass this test with progressively higher scores. • Resistance to penetration by synthetic blood under conditions of continuous liquid contact. This test is graded pass/fail based on visual inspection. • Resistance to penetration by bloodborne pathogens is what earns Level 4 gowns the highest classification. A non-infectious bacteriophage similar in size and shape to hepatitis C, the smallest bloodborne pathogen, is introduced through liquid contact. Resistance to penetration is reported as pass/fail. D isposable but indispensable, surgical gowns are a key component of infection prevention efforts for your patients. They're also the front line of barrier protection for your OR's occupants. The factors that determine just how effective they are in shielding your surgeons, staff and patients can help you decide which type to purchase, but trying them on will ensure that the protection you choose is also practical. Here's a review of the most important selection criteria. — Outpatient Surgery editors 3 Barrier protection. Surgical gowns, which the FDA regulates as medical devices, must meet a minimum of Level 1 barrier protection in their critical zones, the areas where direct contact with blood and bodily fluids is most likely: the front of the gown from the collarbones to below the waist, the sleeves' forearms, and any seams or points of attachment. If a gown's back panels don't meet Level 1 criteria, the gown (and not just its packaging) must be labeled with a warning. Anatomy of a Surgical Gown Inside the barrier that keeps fluids out. 3 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7