A Review of Isolation Gowns in Healthcare: Fabric and Gown Properties

Abstract

The threat of emerging infectious diseases including Ebola hemorrhagic fever, pandemic influenza, avian influenza, Hepatitis B, Hepatitis C, and SARS has highlighted the need for effective personal protective equipment (PPE) to protect healthcare workers (HCWs), patients, and visitors. PPE is a critical component in the hierarchy of controls used to protect HCWs from infectious hazards. HCW PPE may include gowns, respirators, face masks, gloves, eye protection, face shields, and head and shoe coverings. Important research has been conducted in certain areas, such as respirators and protective masks, but studies in other areas, particularly gowns, are scarce. Gowns are identified as the second-most-used piece of PPE, following gloves, in the healthcare setting. According to the Centers for Disease Control and Prevention’s Guideline for Isolation Precautions, isolation gowns should be worn to protect HCWs’ arms and exposed body areas during procedures and patient-care activities when anticipating contact with clothing, blood, bodily fluids, secretions and excretions. Isolation gowns currently available on the marketplace offer varying resistance to blood and other bodily fluids depending on the type of the material, its impermeability, and wear and tear. While some studies show no benefit of the routine use of isolation gowns, others demonstrate that its use is associated with a reduced infection rate. This paper reviews isolation gowns in healthcare settings, including the fabrics used, gown design and interfaces, as well as critical parameters that affect microorganism and liquid transmission through fabrics.

Intubation and Ventilation amid the COVID-19 Outbreak

“…GownsA clean, nonsterile, long-sleeved, and waterproof gown. Isolation gowns are defined as a gown intended to protect healthcare patients and personnel from the transfer of microorganisms, body fluids, and particulate material, whereas protective gowns refer to impervious gowns with a high level of protection 57. Medical maskSurgical or procedure masks that are flat or pleated (some are like cups); they are affixed to the head with straps.…”

A systematic risk-based strategy to select personal protective equipment for infectious diseases

“…The level of protection offered by PPE used in health care settings has not been evaluated in depth. Product evaluation tests typically involve only components of the PPE (eg, the penetration of fluid through the textile, not the seams in the garment or performance in the field), 18,19 and federal agency representiatives and others have been called on to test the permeability of textiles to specific infectious agents. 37 Although there is room to improve the realism of this type of product testing, it is equally important to evaluate how PPE ensembles perform in the field, where human behavior and individual pieces of PPE influence protection.…”

Water Permeability of New and Maximum Laundered Isolation Gown Cuffs

“…Protective gowns are the second most used personal protective equipment (PPE) in healthcare behind gloves (Balci & D'Alessandro, 2015;Kilinc, 2016). Isolation gowns have varying barrier effectiveness based on the type of material, type of fiber, the permeability of the fabric, and number of uses (Lovitt et al, 1992).…”

“…Isolation gowns are classified as either "disposable/single-use" or "reusable/multi-use". Disposable (singleuse) isolation gowns are designed to be discarded after a single use and are typically constructed of nonwoven materials alone or in combination with materials that offer increased protection from liquid penetration, such as plastic films (Leonas, 2005;Kilinc, 2015).…”

“…Studies have shown the cuffs can be extremely susceptible to contamination with blood and bodily fluid depending on the task performed, duration, type and number of gloves, and amount of blood or fluid present (Goldfrank & Liverman, 2007;Telford & Quebbeman, 1993). Since there is no legal requirement or a voluntary consensus standard for isolation gown cuffs to meet barrier performance criteria, they are mostly made of materials that provide little to no barrier resistance, such as polyester, cotton, or blends (Kilinc, 2015).…”