Raising the bar on surgical gowns and drapes

Healthcare Purchasing News, Sept, 2004 by Jeannie Akridge

There's been a lot of chatter lately about gowns and drapes particularly from materials managers who are charged not only with finding the highest protection and optimal comfort at the lowest price; but also with wading through a variety of marketing claims, industry standard and non-standard tests.

Here's what one purchasing analyst had to say about her hospital's recent RFP for packs and kits, and an eventual vendor change.

"One of the primary drivers for our re-evaluation of sterile drapes and gowns was concern about penetration," said Leslie DeBaun, purchasing at Delnor-Community Hospital in Geneva, IL. "We also had some concerns about customer service from the vendor that we had been using. We invited manufacturers of the custom sterile single use fabric products (gowns and drapes) to participate in a bidding and evaluation process."

"We then formed a core group of people from Purchasing and Surgery to manage the process. The coordination of the testing of all products was done between surgery, the vendors and purchasing. Each department ran its own tests in the clinical setting. Physicians were strongly encouraged to try the gowns and test the drapes to approve or disapprove them."

One hospital's quest Barrier protection

"As indicated above, strike-through was of major concern," said DeBaun. "AAMI liquid barrier protection classifications were part of the information referenced during the evaluation. Dung the test process, one of the gowns failed to perform when the surgeon was not adequately protected from fluid during major abdominal surgery."

Flammability

"Of great concern, and a major issue with AORN, is the flammability property of fabric. The statements given by some sales representatives seemed to have conflicting information, noted DeBaun. "The vendors have written material on combustibility and flammability. They may reference the National Fire Protection Association test method 702-1980 either as an acceptable or unacceptable test. They may reference the Federal Flammable Fabric Act, Title 16, CFR 1610. They may reference testing performed by a private party. Each type of fabric has different flammability properties; manufacturers can have several different fabrics. It is important to compare "apples to apples" on the types of fabric being evaluated between various vendors. In all this, we were aware that the OR has an oxygen enriched environment that is a contributing factor to fire.

"Due to the large amount and sometimes conflicting information we were given on the issue, the idea of a "fire drill" evolved, which was led by our Surgery Educator, Brenda Yates. A group of people assembled to witness igniting fabrics from the different vendors under a well-controlled environment away from the hospital and with security on-hand to ensure safety. The results were quite profound. One manufacturer's fabric burned only when kept in constant flame and only at the flame. Another lit like a sheet of newspaper and burned like the paper/plastic material from which it was made. A billowing black smoke was produced.

By igniting small pieces of the fabric we had evidence to consider in our overall evaluation."

Breathability

"One physician is only comfortable in cooler fabrics," said DeBaun. "For that physician we tested and then later, decided to stock a gown that has more breathability yet maintains the other properties we desired."

Drapability, linting

"We checked for drapability. Also, it was important to keep linting to a minimum."

Evaluation outcomes

"During the evaluation process that lasted several months, Purchasing negotiated pricing and value-added offers from the vendors involved.

As of today, we have changed almost all our apparel and drapes to a new vendor. We still have a few special drape requirements that may only be met when a new model is made or we may need to order a custom drape. Overall, we have provided to our staff and physicians an improved product, decreased safety rinks and saved money," concluded DeBaun.

Will AAMI standards clear the waters?

HPN talked with many of the major surgical drape and gown suppliers to find out how their products stack up to the new AAMI liquid penetration standards, what new developments have come down the pipeline in terms of new fabrics, and other factors to consider in drape and gown selection.

With the new AAMI standards that were discussed in our March 2004 issue ("Barrier Protection", also available online), and that have been ten years in the making, those involved in the purchasing and use of surgical gowns and drapes now have an industry accepted standard for measuring barrier protection.

As explained by Lisette Swenson, brand manager, US, Barrier, Molnlycke Health Care Inc., "AAMI has tried to clear the waters and say, 'manufacturers, you have to have clearly stated claims, and you have to back that up with your test methodology and where your fabric met it according to our guidance. And although it's not legally required, I think everyone pretty well accepts that it's going to be the professional technical guidance."