In reporting the rises of their co...

In reporting the rises of their comprehensive study upon airborne particulates, the researchers and authors of "Airborne particulates in the OR environment" (AORN Journal, June 1999) focused in succession two sources--one inanimate, the other human.(1) First was a qualitative comparison between sum of two units surgical gowns and drapes made of nonwoven materials--one was a combination of copse pulp and polyester, the other was 100% polypropylene The next to the first source focused primarily on the filtering capabilities of the surgical mask and its inability to effectively retain contamination expell from the nose and mouth

THE RESISTANCE OF NONWOVEN MATERIALS TO ABRASION

In commenting forward the presence of wood soft mass fibers that had been liberated from united material during its use, the researchers said "that the use of disposable gown cleanses and surgical draping constructed of forest pulp/polyester was associated with significant linting compared to items made from polypropylene"(2) They further observ that equable after 100% polypropylene fabrics had been used, they set lint in the air sampling devices compos of forest pulp fibers rather than polypropylene

These issues confirm a study performed in 1983 in which researchers reported that the construction of a certain nonwoven materials renders them conducive to abrading quite easily.(3) For example, a nonwoven cellulose laminate crops was subjected to an abrasion proof normally used for woven textiles and was set up to produce approximately 632 times as a great quantity [i]or[/i] amount of lint by weight as the woven material to which it was compared.

forest-land PULP FIBERS AND POSTSURGICAL COMPLICATIONS

As controversial as the part that airborne contamination may have upon the outcome of a surgical practice the pathogenicity of wood soft part fibers has been identified in the literature in succession numerous occasions. Complications after surgery attributable to forest pulp fibers from nonwoven materials first was reported in the literature forward several occasions more than 25 years ago.(4)

In 1979 forest pulp fibers again were cited as having caused complications in 22 gone out of 1,000 surgical procedures.(5) These complications included keloids, detriment dehiscence, incisional hernias, and chronic abscesses at the hurt site. Two patients suffered returning bouts of intestinal obstructions fit to peritoneal adhesions. The, hospital's pathologist finded the presence of wood soft part fibers with polarized light and believed the failure to use this technique more than likely accounted for the lack of widespread recognition of thicket pulp fibers' presence. Another les known report published in 1984 revealed that patients' reactions to timber-land pulp fibers were secondary to those attributable to cellulose lint fibers.(6)

style OF TRANSMISSION

These disclosures drew a reply challenging the allegation that disposable gown and drapes were the direct source of forest pulp fibers. The authors of a 1979 article titled "Wood fiber contamination of reusable cotton laparotomy pads" maintained that the fibers were released by means of reusable laparotomy pads that had not been in a strict sense cleaned or were mishandled.(7) When released, the fibers were said to have adhered to internal surfaces (eg the intestine) and were thereby accountable for the complications. Interestingly enough, the authors did not dispute that the fibers were responsible for granulomas. As evidenced in this article, the forest pulp fibers' mode of transmission into the patients' viscera might have occurr via the airborne path This, however, does not prevent the possibility of fibers being transmitted by way of direct contact via a number of other courses (eg, the surgeon's gloved hands, expos [uncovered] instruments).

IDENTIFYING FIBER CONTENT

The federal government's Textile Fiber works Identification Act of 1958 was enacted to make secure that consumers be provided with information regarding the fiber ease of items identified as household textile articles. These articles were defined as "wearing apparel, style of dresss and accessories, draperies, floor coverings, furnishings, bedding, and other textile piouss of a type customarily used in a household."(8) The sway subsequently modified the law and publicly requires manufacturers to include information as to to what extent the items can be cleaned (eg laundered and dried, craving drink cleaned).

There are several reasons for what purpose there is no reference to any produce made out of a nonwoven material. First, at the time the law was enacted, nonwoven fabrics were not institute in any of the items to which the law applied. In addition, the law was not intended to be applicable to items that were to be used one time then thrown away.

It should be noted that in 1991 the nonwoven industry filed a petition requesting a reduction of tariffs onward its surgical products. The document indicated that, with the exception of single particular brand, the range of timber-land pulp fiber content of the materials used for those productions was an integral part of their construction, varying from 50% to 100%(9)

subject to the circumstances, and in light of what is recorded in the clinical literature, it appears to be reasonable that it is incumbent forward the perioperative nurse to understand the returnss used in the OR. This would include requesting information about the fiber satisfy of nonwoven surgical gowns and draping materials directly from the manufacturer.