- •No isolation gown standard exists that includes both performance and design criteria.
- •Infection preventionists face difficulties in the selection of isolation gowns.
- •End users have limited information on the level of protection provided by isolation gowns.
- •There is an urgent need to establish performance and design criteria for isolation gowns.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to American Journal of Infection Control
- Virus transfer from personal protective equipment to healthcare employees' skin and clothing.Emerg Infect Dis. 2008; 14: 1291
- Methods for the recovery of a model virus from healthcare personal protective equipment.J Appl Microbiol. 2009; 106: 1244-1251
- Survival of bacteria on respirator filters.Aerosol Sci Technol. 1999; 30: 300-308
- Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.Infect Control Hosp Epidemiol. 2008; 29: 583-589
- Contamination of protective clothing and nurses' uniforms in an isolation ward.J Hosp Infect. 1983; 4: 149-157
- Nursing and physician attire as possible source of nosocomial infections.Am J Infect Control. 2011; 39: 555-560
- Hospital gowns as a vehicle for bacterial dissemination in an intensive care unit.Braz J Infect Dis. 2004; 8: 206-210
- Quantitative studies on fabrics as disseminators of viruses. I. Persistence of vaccinia virus on cotton and wool fabrics.Appl Microbiol. 1966; 14: 55-59
- Quantitative studies on fabrics as disseminators of viruses. V. Effect of laundering on poliovirus-contaminated fabrics.Appl Microbiol. 1971; 21: 227-234
Hofer D. The role of textiles in chains of infection. Arab Medical Hygiene. 2011. Available from: http://www.amhmagazine.com/article.php?article_id=802. Accessed April 13, 2013.
- Survival of Enterococci and Staphylococci on hospital fabrics and plastic.J Clin Microbiol. 2000; 38: 724-726
- Quantitative studies on fabrics as disseminators of viruses. II. Persistence of poliomyelitis virus on cotton and wool fabrics.Appl Microbiol. 1966; 14: 183-188
- Biocidal textiles can help fight nosocomial infections.Med Hypotheses. 2008; 70: 990-994
- Survival of some medically important fungi on hospital fabrics and plastics.J Clin Microbiol. 2001; 39: 3360-3361
- Quantitative studies on fabrics as disseminators of viruses. 3. Persistence of vaccinia virus on fabrics impregnated with a virucidal agent.Appl Microbiol. 1967; 15: 921-927
- Bacterial flora on the white coats of medical students.J Hosp Infect. 2000; 45: 65-68
- Microbial flora on doctors' white coats.BMJ. 1991; 303: 1602-1604
- Bacterial contamination of uniforms.J Hosp Infect. 2001; 48: 238-241
- Survival of influenza viruses on environmental surfaces.J Infect Dis. 1982; 146: 47-51
- Survival and disinfection of parainfluenza viruses on environmental surfaces.Am J Infect Control. 1990; 18: 18-23
- Penetration of gown material by organisms from the surgical team.Clin Orthop. 1979; 141: 237-246
- Isolation gowns: a false sense of security?.Am J Infect Control. 1992; 20: 185-491
- Variability of laboratory coat resistance to strikethrough.Clin Chem. 1994; 40: 459-463
- Microorganism protection.in: Scott R.A. Textiles for protection. Woodhead Publishing-CRC Press, Boca Raton [FL]2005: 441-464
- Effects of discontinuing cover gowns on a postpartal ward upon cord colonization for the newborn.JOGN Nurs. 1983; 12: 399-401
- Nursery routines and staphylococcal colonization of the newborn.Pediatrics. 1969; 44: 640-646
- Gowning on a postpartum ward fails to decrease colonization in the newborn infant.Am J Dis Child. 1990; 144: 1031-1033
- A randomized controlled trial of a nursery ritual, wearing cover gowns to care for healthy newborns.Birth. 1990; 17: 25-30
- Bacteriologic and clinical evaluation of gowning in a premature nursery.J Pediatr. 1971; 78: 883-886
- Failure of the overgown to prevent nosocomial infection in a pediatric intensive care unit.Pediatrics. 1986; 77: 35-38
- Do gowns prevent infection in neonatal intensive care units?.J Hosp Infect. 1989; 14: 159-162
- Evaluation of modified gowning procedures in a neonatal intensive care unit.Am J Dis Child. 1981; 135: 650-652
- Reduction of nosocomial infection during pediatric intensive care by protective isolation.N Engl J Med. 1989; 320: 1714-1721
- Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions.N Engl J Med. 1987; 317: 329-334
- Prospective controlled study of four infection-control procedures to prevent nosocomial infection with respiratory syncytial virus.Lancet. 1992; 340: 1079-1083
- A review of single-use and reusable gowns and drapes in healthcare.Infect Control Hosp Epidemiol. 2001; 22: 248-257
- Surgical gown: a critical review.J Ind Textiles. 2009; 38: 205-231
- Image analysis for testing and evaluation of the barrier effect of surgical gowns.JTATM. 2003; 3: 2
- Comparison of nonwoven and woven gowns and drape fabric to prevent intraoperative wound contamination and postoperative infection.Am J Surg. 1986; 152: 505-509
- Direct measurement of bacterial penetration through surgical gowns: a new method.J Hosp Infect. 2002; 50: 281-285
- Reducing wound infections. Improved gown and drape barrier performance.Arch Surg. 1987; 122: 152-157
- Factors that influence the effectiveness of surgical gowns in the operating theater.Eur J Surg. 1997; 163: 597-604
- In-use evaluation of surgical gowns.Surg Gynecol Obstet. 1992; 174: 369-375
- Barrier efficiency of surgical gowns: are we really protected from our patients' pathogens?.Arch Surg. 1991; 126: 756-763
- Assessing the risk of blood exposure in the operating room.Am J Infect Control. 1993; 21: 351-356
- The use and failure rates of protective equipment to prevent blood and bodily fluid contamination in the obstetric healthcare worker.Obstet Gynecol. 1998; 92: 131-136
- Prolonged contact with blood alters surgical gown permeability.Am J Infect Control. 1993; 21: 249-256
- Effect of laundering on the barrier properties of reusable surgical gown fabrics.Am J Infect Control. 1998; 26: 495-501
- The relationship of selected fabric characteristics and the barrier effectiveness of surgical gown fabrics.Am J Infect Control. 1997; 25: 16-23
- Methods for determining the barrier efficacy of surgical gowns.Am J Infect Control. 1993; 21: 368-374
- Liquid barrier properties of nine surgical gown fabrics.INDA Journal of Nonwovens Research. 1991; 3: 14-20
- Masking and gowning in nurseries for the newborn infant.Br Med J. 1958; 1: 76-79
- The use of gowns and masks to control respiratory illness in pediatric hospital personnel.J Pediatr. 1981; 99: 746-750
- A study of the value of simple protective isolation in patients with granulocytopenia.N Engl J Med. 1981; 304: 448-453
- Nosocomial respiratory syncytial viral infections. Should gowns and masks be used?.Am J Dis Child. 1981; 135: 512-515
- A prospective study to determine whether cover gowns in addition to gloves decrease nosocomial transmission of vancomycin resistant enterococci in an intensive care unit.Infect Control Hosp Epidemiol. 2002; 23: 424-428
- A gown is a gown is a gown: or is it?.Infect Control Hosp Epidemiol. 2003; 24: 234-235
- Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance.J Clin Microbiol. 1994; 32: 1148-1153
- Controlling vancomycin-resistant enterococci.Infect Control Hosp Epidemiol. 1995; 16: 634-637
- A comparison of the effect of universal use of gloves and gowns with that of glove use only on acquisition of vancomycin-resistant enterococci in a medical intensive care unit.Ann Intern Med. 1996; 125: 448-456
- To gown or not to gown: the effect on acquisition of vancomycin-resistant enterococci.Clin Infect Dis. 2002; 35: 18-25
- Infection-control measures reduce transmission of vancomycin-resistant enterococci in an endemic setting.Ann Intern Med. 1999; 131: 269-272
- Epidemiology of isolation precautions.Infect Control Hosp Epidemiol. 1991; 12: 303-307
- The role of gowns in preventing nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA): gown use in MRSA control.Infect Control Hosp Epidemiol. 2006; 27: 191-194
- Transfer of Staphylococcus aureus via nurses' uniforms.J Hyg (Lond). 1973; 71: 799-813
- Bacterial dispersion in relation to operating room clothing.J Hyg (Lond). 1976; 76: 367-378
- Preventing the airborne spread of Staphylococcus aureus by persons with the common cold: effect of surgical scrubs, gowns, and masks.Infect Control Hosp Epidemiol. 2007; 28: 1148-1154
- Determination of surgeon-generated pressures during various surgical procedures in the operating room.Am J Infect Control. 1995; 23: 237-246
- Bacterial strike-through of re-usable surgical drapes: the effect of different wetting agents.J Hosp Infect. 2002; 52: 52-55
- A comparison of reusable and disposable perioperative textiles: sustainability state-of-the-art.Anesth Analg. 2012; 114: 1055-1066
- Commercially available surgical gowns do not prevent penetration by HIV-I.Surg Forum. 1990; 41: 77-80
- Evaluation of the protective value of hospital gowns against blood strike-through and methicillin-resistant Staphylococcus aureus penetration.Am J Infect Control. 1998; 26: 85-93
- ANSI/AAMI:PB70:2012 liquid barrier performance and classification of protective apparel and drapes intended for use in healthcare facilities. Association for the Advancement of Medical Instrumentation, Arlington [VA]2012
- Effect of laundering on the barrier properties of reusable surgical gown fabrics.Am J Infect Control. 1999; 27: 304-305
- Larson E.L. Catharyn T.L. Preventing transmission of pandemic influenza and other viral respiratory diseases: personal protective equipment for healthcare workers: update 2010. National Academies Press, Washington, DC2011
U.S. Food and Drug Administration. FDA's role in regulating PPE. 2012. Available from: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/PersonalProtectiveEquipment/ucm056084.htm. Accessed March 3, 2012.
US Food and Drug Administration. CFR - Code of Federal Regulations Title 21. Available from: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=878.4040. Accessed September 9, 2015
Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; final rule. 29 CFR Part 1910:1030. Fed Regist 1991;56:64003-182. Amended 77 FR 19934, April 3, 2012
American Society of Testing and Materials. New Specification for non-sterile isolation gowns intended for use in health care facilities. Available from: http://www.astm.org/DATABASE.CART/WORKITEMS/WK33313.htm. Accessed September 6, 2015.
- 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings.Am J Infect Control. 2007; 35: S65-S164
- AAMI-TIR 11 technical information report: selection and use of protective apparel and surgical drapes in health care facilities. Association for the Advancement of Medical Instrumentation, Arlington [VA]2005
- AATCC 42-2007 water resistance: Impact Penetration Test. American Association of Textile Chemists and Colorists, Research Triangle Park [NC]2007
- AATCC 127-2008 water resistance: Hydrostatic Pressure Test. American Association of Textile Chemists and Colorists, Research Triangle Park [NC]2008
- Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Synthetic Blood. ASTM International, West Conshohocken [PA]2014 (Available from: http://www.astm.org. Accessed September 7, 2015)
- Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Blood-Borne Pathogens Using Phi-X174 Bacteriophage Penetration as a Test System. ASTM International, West Conshohocken [PA]2013 (Available from: http://www.astm.org. Accessed September 7, 2015)
Pear SM, Smith SM. Standard precautions confirmed. Available from: http://www.kchealthcare.com/media/13929355/h1042_08_01%20ci_stnd%20f.pdf. Accessed April 13, 2012.
- ASTM F2407-2006 standard specification for surgical gowns intended for use in healthcare facilities. ASTM International, West Conshohocken [PA]2006
- ASTM F1819-07 standard test method for resistance of materials used in protective clothing for penetration by synthetic blood using a mechanical pressure technique. ASTM International, West Conshohocken [PA]2007
- ASTM F903-10 standard test method for resistance of materials used in protective clothing to penetration by liquids. ASTM International, West Conshohocken [PA]2010
- AAMI/ANSI ST65:2008/R(2013) reprocessing of reusable surgical textiles for use in health care facilities. Association for the Advancement of Medical Instrumentation, Arlington [VA]2013
- NFPA 1999: standard on protective clothing for emergency medical operations. National Fire Protection Association, 2013
- Recommended practices for selection and use of surgical gowns and drapes.AORN J. 2003; 77 (213): 206-210
Association of Surgical Technologists. Standards of practice for gowning and gloving. 2014. Available from: http://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Standard_%20Gowning_and_Gloving.pdf. Accessed December 13, 2014.
- Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee.Am J Infect Control. 1998; 26: 289-354
- Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.Am J Infect Control. 1999; 27 (quiz 133-4; discussion 96): 97-132
Centers for Disease Control and Prevention. Guidance on personal protective equipment to be used by healthcare workers during management of patients with Ebola virus disease in U.S. hospitals, including procedures for putting on (donning) and removing (doffing). 2014. Available from: http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html. Accessed in November 2, 2014.
Centers for Disease Control and Prevention. Considerations for selecting protective clothing used in healthcare for protection against microorganisms in blood and body fluids. 2014. Available from: http://www.cdc.gov/niosh/npptl/topics/protectiveclothing/. Accessed December 24, 2014.
The Healthcare Laundry Accreditation Council. Accreditation standards for processing reusable textiles for use in healthcare facilities. 2006. Available from: http://www.hlacnet.org/HLAC_Standards_042006.pdf. Accessed July 2014.
Elixhauser A, Steiner C. Infections with methicillin-resistant Staphylococcus aureus (MRSA) in U.S. hospitals, 1993–2005. Available from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb35.pdf. Accessed April 3, 2012.
World Health Organization. 10 facts on patient safety. Available from: http://www.who.int/features/factfiles/patient_safety/en/index.html. Accessed April 2 2012.
- Eliminating hospital acquired infections: is it possible? Is it sustainable? Is it worth it?.Trans Am Clin Climatol Assoc. 2011; 122: 103-114
- Compliance with routine use of gowns by healthcare workers (HCWs) and non-HCW visitors on entry into the rooms of patients under contact precautions.Infect Control Hosp Epidemiol. 2007; 28: 337-340
- A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions.J Clin Nurs. 2008; 17: 157-167
- Inverse correlation between level of professional education and rate of handwashing compliance in a teaching hospital.Infect Control Hosp Epidemiol. 2008; 29: 534-538
- Effect of educational program on compliance with glove use in a pediatric emergency department.Am J Dis Child. 1992; 146: 1355-1358
- All dressed up and ready to go.HPN Hosp Purch News. 2008; 32: 46-47
Kimberly Clark. Kimberly-Clark new isolation gown portfolio provides AAMI protection for staff and patients. 2008. Available from: http://www.kchealthcare.com/docs/AAMI%20Prss%20Rls.pdf. Accessed March 10, 2010.
- Isolation Gown Use, Performance and Potential Compliance Issues Identified by Infection Control Professionals.Am J Infect Control. 2012; 40: e74-e75
- A critical review of a century's progress in surgical apparel: how far have we come?.J Am Coll Surg. 2000; 191: 554-568
- Textile products and prevention of hospital acquired infections: understanding the hospital perspective. Journal of Medical Marketing: Device.Diagnostic and Pharmaceutical Marketing. 2011; 11: 156-164
Rucker M. Factors influencing healthcare workers' opinions about protective clothing and drapes in the operating room. In: Proceedings of the Sustainable Textiles and Medical Protection Conference (STAMP)., 2010 Jun 1-2; Davis [CA].
- Protective clothing for health care workers: liquidproofness versus microbiological resistance.in: McBriarty J.P. Henry N.W. Performance of protective clothing. ASTM STP 1133. 2nd ed. ASTM, Philadelphia [PA]1992: 65-82
- Gowns: selection on a procedure-driven basis.Infect Control Hosp Epidemiol. 1994; 5: 713-716
- False faith in the surgeon's gown and surgical drape.Am J Surg. 1952; 83: 125-126
- Selecting protective apparel for the degree of exposure anticipated.Infect Control Hosp Epidemiol. 2000; 21: 436
Conflicts of interest: None to report.