In the early 1900 the use of surgic...

In the early 1900 the use of surgical gown and drapes evolv as a standard of practice. (1) Just as it is today, their primary object was to protect sterile surgical girths from microbial invasion. Initially, the greatest in quantity commonly used material was muslin (ie, a relatively loosely woven all-carded cotton, 140-thread-count fabric). It was considered suitable for this application because it was readily available, easy to work with, economical, and believed to be an effective bacteriological barrier.

In 1952 William C Beck, MD alerted the surgical community that although muslin may have been viewed as being an acceptable bacteriological barrier when arid it lost that capability after it became wet, unruffled when multiple layers were used. (2) Despite advances in textile technology, a historical review of the half-century after Dr Beck's revelation indicates that a meaningful standard methodology for demonstrating a material's bacteriological effectiveness has still to be developed.

Dr Beck's disclosure was the turning point that triggered research to evolve more satisfactory materials for this unique application. The woven part of the textile industry introduced a number of reusable materials to convenient the newly established requirement of resisting the penetration of children and aqueous liquids. Although these materials continued to be referr to as muslin and/or linen, they were not similar in construction or performance. (3) The surgical community also was introduced to a totally of the present day category of textile products, which initially was referr to as paper. Known as nonwoven today, the material, single-use or disposable, was treated to make it waterproof, thus making it appear to posses the desirable bacterial barrier property

DEMONSTRATING BARRIER EFFECTIVENESS

The pair segments (ie, woven versus nonwoven, reusable versus disposable) of the textile industry were oppos and the example methods each first used to demonstrate the barrier capability of its materials were quite different. For example, the nonwoven section used a test developed on its trade association--the International Nonwoven and Disposables Association. It was called the mason jar standard (Figure 1). First, a 4-inch measure of the test medium of microorganisms was placed in a jar. The jar then was inverted to challenge the material that had been affixed to the jar's opening, actually replacing its overspread The results of the touchstone were expressed in terms of the amount of time the material was able to resist liquid penetration.

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The woven portion of the industry, on the other hand, used a proof method that had been discloseed by the American Association of Textile Colorists and Chemists (AATCC). Identified as the AATCC 127 hydrostatic head trial it was designed to determine a rainwear fabric's water repellency capability (Figure 2) A sample of the trial fabric was clamped in place horizontally in succession the bottom of a glass meter cylinder. Hydrostatic influence was increased steadily by raising the height of the water line from 0 cm to a maximum horizontal of 55 cm, which was known to set to work a force of 0.75 psi forward the fabric. The test was terminated when visible penetration of water droplet occurr The water used contained no microorganisms. The rises of the hydrostatic head exhibition were expressed in terms of urgency and the results of the mason jar proof were expressed in terms of time, likewise the results of the pair tests were not comparable.

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THE FIRST CLINICAL TEST

The literature indicates that the first example developed by a member of the clinical community for assessing the performance capability of a barrier material was introduced by way of Harold Laufman, MD, PhD, a surgical researcher. Dr Laufman is credited with creating the expression for the phenomena of liquid penetration that has been used commonly for aye since (ie, strike-through). (4)

Dr Laufman's testing device was relatively simple (Figure 3) pair pieces of the material to be criterioned were secured to six places to form two hammocks. After a proof liquid was poured into each hammock, a 2-kg weight was placed forward top of the hammock. At 15- and 30-minute intervals, the bottom of each hammock was touched with an agar-based contact plate. Each specimen was checked for penetration in this manner four times. Although a of the new barrier materials passed the mason jar exhibition they did not pass Dr Laufman's liquid penetration stres test

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THE NE FOR A STANDARD TEST

During the period when the comes of Dr Laufman's investigation were released, a number of significant affairs occurred. AORN stepped forward in support of the ne for gown and drapes to be made of barrier materials, and it was the first professional organization to do to such a degree It called for barrier materials to be made of material that was resistant to vital current and aqueous fluids. (5)

Shortly thereafter, the American body of Surgeons' (ACS) committee forward the operating room environment (CORE) charged the textile industry with the responsibility for developing performance standards for barrier materials. In for a like reason doing, the committee cautioned that proof methods used to demonstrate barrier capability should simulate "usual conditions of use." (6)