What are medical drapes and gowns?
What are the types of medical drapes and gowns?

Medical gowns are made of functional fabrics designed to protect healthcare professionals and patients from the transfer of microorganisms, bodily fluids and particulate matter. Medical drapes are also functional fabrics designed to isolate a site of surgical incision from microbial or other contamination. Medical drapes and gowns can be disposable (intended for one time usage only) or reusable. There are many factors involved when choosing medical fabrics and gowns. Those factors are:

1. Barrier to liquid penetration. This helps protect the healthcare professionals from patient blood, bodily fluids and liquids used in irrigation during surgery.
2. Barrier to penetration by bacteria laden aerosol or dry particles containing spores. This means that when healthcare professionals lean up against the operating room table their gowns can create a bellows effect which forces air through the gown. This air transports skin cells and bacteria into the surgical field. It can also protect the healthcare professional when they are using saws or drills – those instruments can generate air flow causing skin cells and bacteria to be released into the surgical field.
3. Abrasion resistance. When you wear any apparel there is abrasion against the fabric. Think of leaning your arm on a table when you’re sitting down. The fabric is rubbing against the table which can cause degradation of the material. This abrading can also create lint which can be released into wounds.
4. Strength. Medical drapes and gowns need to be strong to stand up to stresses in wet and dry conditions, i.e., withstand rupturing, tearing and puncturing.
5. Lint and particulate generation. Fabrics can generate lint or other particles that could carry microorganisms. These microorganisms can be from the healthcare professional or someplace in the operating room. This could interfere with the patient’s autoimmune system heightening the possibility for infection. Plus, you could get adhesions and granulomas (inflammation of tissue) from the particles themselves.
6. Flammability. Healthcare professionals use surgical lasers, sparking tools, endoscopic fiberoptics, electrosurgical units and high speed drills or saws. All of these could ignite and cause fires, since operating rooms are oxygen rich environments. Having fire retardant drapes and gowns protect the healthcare professional and the patient.
7. Electrostatic properties. The United States has banned the usage of flammable anesthesia which helps curb the possibility of fires in the operating room. But using oxygen rich ventilation and alcohol based surgical hand scrubs and patient skin prep products increases the risk of fires in the OR. Fabrics should be able to dissipate the electrostatic charge, so that the charge won’t build up and produce a spark.
8. Comfort. Healthcare professionals need to be comfortable when they are in the OR. They can be in the OR for hours; and if they are distracted by irritating fabric or confining fabric, then that discomfort will divert their attention from the patient and prevent full concentration on the task at hand.
9. Reusable gowns. Reusable drapes and gowns must still be able to perform after multiple launderings. Disposable drapes and gowns are the first choice of the majority of healthcare professionals in the USA because they are only worn once and do not have the disadvantage of having to be collected and recycled.

Medical drapes and gowns are considered medical devices in the United States and Europe because they are designed to perform a function, i.e., prevent infection. Medical drapes and gowns are considered as a Class I medical device, since they are non-invasive medical products. There are four levels of medical devices with the first class being the least invasive device and four being the most invasive device.

Where are medical drapes and gowns used?

Medical drapes and gowns are used in operating rooms and anywhere else where a surgical procedure may be performed (some procedures are performed in doctors’ offices and clinics).

Nonwoven medical drapes and gowns

Single Use Nonwoven medical drapes and gowns are the first choice of healthcare professionals (over 85% of hospitals use single-use gowns and over 90% use medical single-use drapes). Professionals choose single-use because they feel they are superior to reusables. They have confidence that they will be protected from infection.

The North American sales to end users of medical/surgical products made from nonwovens are estimated at $1.3 billion during 2005. Surgical gowns and drapes is the largest portion of this amount with sales of $850-900 million during the year. The North American medical markets during 2005 consumed 1.9 billion square meters of nonwoven materials with an estimated roll goods value of $570 million. In terms of tonnage, this volume was equivalent to 124,000 tonnes of various types of medical nonwovens. Within the medical/surgical market, disposable surgical gowns, drapes, and pack parts made from nonwovens represent roughly a 1.2 billion square meter market worth about $428 million.

There are different types of materials that can be used in the construction of drapes and gowns. Nonwoven drapes and gowns have 4 levels of barrier performance. Here are examples of the types of materials that are used in gowns:

LEVEL 1: Spunbond Polypropylene and Spunlace PET /Woodpulp - very light material meant to be used where there is little to no contact with blood or bodily fluid.

LEVEL 2: Medium weight SMS (spunbond-meltblown-spunbond) and Spunlace PET/Woodpulp - made out of three or more layers providing a more comfortable/breathable barrier. Used in cases of light contact with blood and bodily fluids.

LEVEL 3: Heavy weight SMS (spunbond-meltblown-spunbond) - made out of three (or more SSMMMSS – 7 layers) layers providing a more comfortable/breathable barrier. Used in cases of moderate exposure to blood and bodily fluids.

LEVEL 4: Poly coated - made from SMS polypropylene (PP) or Spunlace PET/Woodpulp material coated with polyethylene (PE). PP is light and comfortable and PE gives a strong barrier to fluids. Used when High contact with blood and bodily fluids is expected.

Re-usable: available in many materials offering varying levels of protection. Used once and then laundered.

Who are the major players in the medical drapes and gowns industry?

1. Cardinal Health (disposable)
2. Kimberly-Clark (disposable)
3. Medline (disposable and reusable)
4. 3M (disposable)
5. Alcon Laboratories (disposable)
6. Angelica Inc. (reusable)
7. DeRoyal Inc. (disposable)
8. Microtek Medical Inc. (disposable)
9. On Qor, Division of All-Pak Inc. (reusable)
10. Precept Medical Products Inc. (disposable)
11. Standard Textile Co. (reusable)
12. Superior Uniform Group (reusable)
13. TIDI Products LLC (disposable)

Medical drape and gown associations

AAMI (Association for the Advancement of Medical Instrumentation)

Facts & Fiction about single-use versus reusable drapes and gowns

Fiction: Reusables provide a big cost advantage.
Fact: Is a $75 gown that’s rated for 70 uses really a better deal than a $3 gown you can only use once? Not necessarily: a survey of 150 hospitals found that the per-use costs of single-use products and reusables are comparable when you consider the comprehensive system costs of materials, labor and overhead involved in acquiring, storing and reprocessing or disposing of gowns under each system. Hospitals are charged additional fees for lost and damaged gowns and drapes.

Fiction: A gown rated for 70 uses will be used 70 times.
Fact: According to a hospital survey, every time an OR linen is used, it stands an average 4% chance of being lost or damaged. This means a reusable products gets used an average of only 22.6 times before it’s lost-not the 70 cycles claimed by manufacturers. You pay for 70 uses and get only 22.6! Your hospital’s loss and damage rate could be even higher!

Fiction: One reusable gown can replace one single-use gown.
Fact: It takes 5-7 reusable linens to do the work of one single-use product. That’s because for every reusable gown in the OR today, you need to buy several more that are being reprocessed for upcoming surgeries. The National Association of Institutional Linen Management says you should buy 5-7 reusables for each linen in use, depending on your laundry’s turnaround time.

Fiction: Reprocessing reusables in-house saves lots of money.
Fact: According to a hospital survey, in-house laundering makes economic sense only if your inventory, assembly and laundry operations run at peak efficiency. If yours doesn’t, the cost of reusables increases.

Fiction: Reusables will become more attractive under managed care.
Fact: Not only do reusables fail to live up to their promised level of cost-savings, but their cost-per-use is difficult to track. This makes it difficult to accurately calculate reusables for patient chargeback-a critical concern in a managed care environment.

Fiction: Reusables are as reliable as single-use products.
Fact: Reusables claim to perform adequately after as many as 70 washings. However, these claims are based on reprocessing conducted in the tightly controlled conditions of the manufacturers’ laboratories. In the real world, reprocessing conditions are not so ideal: Laundry mistakes-such as using water that is too hot or improper rinsing procedures that do not meet standards-can shorten reusable gown life and pose unnecessary risk to patients and OR staff. INDA’s data indicates that controlled processing of reusable gowns does not degrade performance.

Fiction: The risk factor for reusables is comparable to that of single-use products.
Fact: The possibility of early gown failure may add to the hospital’s potential liability, requiring a detailed review by hospital risk managers. This is not the case with singleuse products, which are used only once and whose performance is therefore assured.

Fiction: Switching from single-use products to reusables is easy.
Fact: Whether using an in-house or contract reprocessor, there are many “nuisance” costs in switching from single-use products to reusables: inventory shuffle, staff confusion over packaging, and the need to store blood-soaked laundry until reprocessing.