Reusable versus disposable gowns

Hospital isolation gowns are fabricated from either reusable (multiuse) or disposable (single-use) materials. These 2 basic types of products each have advantages and disadvantages in terms of protection, maintenance, comfort, cost, and environmental impact. Within each of these categories, there is considerable variation in design and performance characteristics.

Disposable 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. Various forms of synthetic fibers (eg, polypropylene, polyester, polyethylene) are used for the construction of disposable isolation gowns. Reusable (multiuse) isolation gowns are laundered after each use and are typically made of 100% cotton, 100% polyester, or polyester-cotton blends. Several studies made comparisons of different materials (eg, reusable, disposable), and with different wearers and produced mixed results. A consistent finding is that, although impermeable materials are effective in reducing the transfer of microorganisms, the thermal comfort of the wearer is compromised. Also, several studies have evaluated penetration of blood, other fluids, and bacteria through surgical gowns and coats; results showed penetration occurs in some the clothing.

A limited number of studies have compared the performance of reusable and disposable isolation gowns. Lovitt et al assessed the resistance to penetration by human blood of 11 types of disposable isolation gowns and 1 type of reusable isolation gown (new and washed 40 and 80 times) at 5 different pressures (0.25-2 psi) and 6 durations (1 second-2 minute). Their testing showed significant differences in the amount of strikethrough (the extent of liquid penetration) allowed by the gowns and demonstrated important differences in the gowns' protective capabilities.

Granzow et al evaluated 6 gown types used in hospitals (1 disposable cover or isolation gown, 3 disposable surgical gowns, and new and washed reusable surgical gowns). Gowns were evaluated for dry spore and Staphylococcus aureus filtration efficiencies and were subjected to 20 time-pressure combinations with methicillin-resistant S aureus–spiked blood to evaluate blood strikethrough and passage of methicillin-resistant S aureus. They found that disposable surgical gowns made of polypropylene, spunbonded-meltblown-spunbonded laminate offered higher fluid resistance than gowns made of polyester-wood pulp blend and that disposable cover gowns made of polypropylene only allowed passage at pressures >1 psi. They concluded gowns therefore should be chosen according to the task performed and conditions encountered.

Several researchers have also considered the effects of laundering on the barrier effectiveness of reusable protective clothing and reached mixed conclusions. These studies mostly used surgical gown samples. In general, researchers have reported that laundering reduces the ability of the fabric to prevent the transmission of microorganisms through the fabrics as a result of abrasion and damage during wearing and the breakdown of the fabric during laundering. Gowns reinforced with other layers were generally reported to remain protective to a defined point (ie, launderings).

Both disposable and reusable gowns have an environmental impact, which was evaluated by researchers. Based on an evaluation of the functional requirements, environmental impact, and economics of gowns, the clear superiority of either reusable or single-use gowns and drapes cannot be demonstrated.