Surgical Gowns:

Selection and
Best Practices
for Protection

A Continuing Education Activity

Sponsored
by
An Online Continuing
Education Activity
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Welcome to

Surgical Gowns:

Selection and Best Practices for Protection

(An Online Continuing Education Activity)

CONTINUING EDUCATION INSTRUCTIONS

This educational activity is being offered online and may be completed at any time.
Steps for Successful Course Completion
To earn continuing education credit, the participant must complete the following steps:
1. Read the overview and objectives to ensure consistency with your own learning needs
and objectives. At the end of the activity, you will be assessed on the attainment of
each objective.
2. Review the content of the activity, paying particular attention to those areas that reflect
the objectives.
3. Complete the Test Questions. Missed questions will offer the opportunity to re-read the
question and answer choices. You may also revisit relevant content.
4. For additional information on an issue or topic, consult the references.
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CONTACT INFORMATION:

2015
All rights reserved
Pfiedler Enterprises, 2101 S. Blackhawk Street, Suite 220, Aurora, Colorado 80014
www.pfiedlerenterprises.com
Phone: 720-748-6144 Fax: 720-748-6196

OVERVIEW

In the perioperative practice environment, prevention of infection for both surgical patients
and health care workers is an overriding goal. The appropriate selection and use of surgical
gowns is an essential component in infection control strategies. Therefore, perioperative
nurses and surgical technologists must be knowledgeable about the key considerations
in selecting and using gowns effectively in the surgical practice setting. This continuing
education activity will provide an overview of the considerations in the selection and use of
surgical gowns as a protective measure for both patients and staff. It will review five criteria
used in the selection of surgical gowns: barrier protection, flammability resistance, low linting,
abrasion resistance, and comfort. The various types of materials used in the manufacture
of surgical gowns, as well as the corresponding industry tests, will be discussed. Best
practices in the donning, use, and removal of surgical gowns will be explored. A case
study will provide the participant with the opportunity to synthesize the information and
evaluate workplace scenario in regards to best practices for surgical gown use.

OBJECTIVES

After completing this continuing nursing education activity, the participant should be able to:
1. Identify five criteria for the selection of surgical gowns.
2. Describe selection criteria for surgical gowns.
3. Discuss best practices for surgical gown protection.

INTENDED AUDIENCE

This continuing nursing education activity is intended for use by perioperative nurses and
surgical technologists who are interested in learning more about best practices related to
the selection and use of surgical gowns.

Credit/Credit Information

State Board Approval for Nurses

Pfiedler Enterprises is a provider approved by the California Board of Registered Nursing,
Provider Number CEP14944, for 2.0 contact hours.
Obtaining full credit for this offering depends upon attendance, regardless of circumstances,
from beginning to end. Licensees must provide their license numbers for record keeping
purposes.
The certificate of course completion issued at the conclusion of this course must be
retained in the participants records for at least four (4) years as proof of attendance.

IACET

Pfiedler Enterprises has been accredited as an Accredited Provider by the International

Association for Continuing Education and Training (IACET).

CEU Statements
As an IACET Authorized Provider, Pfiedler Enterprises offers CEUs for its
programs that qualify under the ANSI/IACET Standard.
Pfiedler Enterprises is authorized by IACET to offer 0.2 CEUs for this program.

Release and Expiration Date:

This continuing education activity was planned and provided in accordance with
accreditation criteria. This material was reviewed and revised September 2015 and can
no longer be used after September 2017 without being updated; therefore, this continuing
education activity expires September 2017.

Disclaimer

Pfiedler Enterprises does not endorse or promote any commercial product that may be
discussed in this activity

Support

Funds to support this activity have been provided by Halyard Health Knowledge
Network

Authors/Planning Committee/Reviewer
Rose Moss, MN, RN, CNOR
Nurse Consultant/Author/Planning Committee
Moss Enterprises

Westcliffe, CO

Judith I. Pfister, RN, BSN, MBA

Program Manager/Planning Committee
Pfiedler Enterprises

Aurora, CO

Aurora, CO

Julia A. Kneedler, RN, MS, EdD

Program Manager/Reviewer
Pfiedler Enterprises
Kathleen B. Stoessel, RN, BSN, MS
Previously Senior Manager, Clinical Education/Author

Roswell, GA

Wava Truscott, PhD

Previously Director, Medical Sciences & Education/Author
Scientific Affairs and Clinical Education

Roswell, GA

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that create a conflict of interest. A commercial interest is any entity producing, marketing,
reselling, or distributing health care goods or services consumed by, or used on, patients.

Activity Authors/ Planning Committee/Reviewer

Rose Moss, RN, MN, CNOR
No conflict of interest
Judith I. Pfister, MBA, RN
Co-owner of company that receives grant funds from commercial entities
Julia A. Kneedler, EdD, RN
Co-owner of company that receives grant funds from commercial entities
Kathleen Stoessel, RN, MS
Previously Employed by company providing grant funds.
Wava Truscott, PhD
Previously Employed by grant funds provider.

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Introduction1,2

Surgical gowns should provide a safe, effective means of protecting patients and health
care workers during use. Patients are at risk of contamination from both endogenous
and exogenous microorganisms; health care workers are at risk for contamination
from various bloodborne pathogens that can be contacted by occupational exposure to
patients blood and body fluids. Therefore, in addition to maintaining an aseptic barrier for
the patients protection, surgical gowns should also provide an effective protective barrier
against the transfer of microorganisms, particulates, and fluids in order to minimize
strike-through and the potential for personnel contamination. Microorganisms can be
transferred through surgical gowns by wicking of fluids and/or pressure. The mechanical
action of pressure can result in both liquid and dry penetration of microbes, if the
pressure exceeds the maximum level of resistance provided by the material. The desired
characteristics of surgical gowns include that they should:
be resistant to penetration by blood and other body fluids as necessitated by
their intended use (data verifying that the gown materials are protective barriers
against the transfer of microorganisms, particulates, and fluids to minimize strikethrough and the potential for personnel contamination should be obtained from
the manufacturer);
maintain their integrity;
be durable;
have an acceptable level of quality (i.e., be free of holes and/or defects);
be constructed of materials that are appropriate to the method(s) of sterilization
(e.g., radiation, steam, and ethylene oxide);
resist combustion, i.e., gowns selected for use should be consistent with accepted
flammability standards that will provide the safest environment for patients and
health care workers;
be comfortable;
contribute to maintaining the wearers desired body temperature, i.e., have the
ability to maintain an isothermic environment for the wearer;
be resistant to tears, punctures, and abrasions;
be as lint-free as possible;
be free of toxic ingredients and allergens (patients and/or health care workers
may experience untoward reactions to toxic ingredients and/or allergens);
be flexible, i.e., the gown conforms loosely to the wearers body;
have limited memory;
be of adequate size to allow for complete closure in the back;
be of adequate sleeve length to prevent cuff exposure outside the sterile glove;
and
have a favorable cost-benefit ratio, i.e., cost should not be the primary
consideration in the selection process.

Gowning Practices in the Perioperative Practice

Environment.3,4,5,6

Gowning is an essential component in establishing and maintaining a sterile field; sterile

gowns create a barrier between the sterile and nonsterile areas. Sterile gowns provide a
barrier between the patient and sterile surgical team member to reduce contamination
of the surgical wound by excluding the skin as a possible contaminant. In addition,
the gown protects personnel from exposure to microorganisms that are present in the
patients blood and other potentially infectious materials (OPIM) or in the atmosphere.

Considerations in Gown Selection Criteria

Surgical gowns selected for use should be composed of a combustion-resistant material

that establishes an effective barrier. Sterile surgical gowns are made of either disposable
single-use, nonwoven materials or reusable materials. With both of these types of
materials, design and performance characteristics vary; the variations stem from tradeoffs in costs, comfort, and the amount of barrier protection provided. The type of gown
material selected depends on the proposed surgical/invasive procedure and the degree
of blood and body fluid splashing expected during the procedure, in accordance with the
Occupational Health and Safety Administration (OSHA) guidelines for the appropriate use
of personal protective equipment (PPE), as follows:7
Personal Protective Equipment -- When there is occupational exposure, the employer
shall provide, at no cost to the employee, appropriate personal protective equipment
such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks and
eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation
devices. Personal protective equipment will be considered appropriate only if it does
not permit blood or other potentially infectious materials to pass through to or reach the
employees work clothes, street clothes, undergarments, skin, eyes, mouth, or other
mucous membranes under normal conditions of use and for the duration of time which
the protective equipment will be used. The type and characteristics of the personal
protective apparel will depend upon the task and degree of exposure anticipated. [Note:
In the healthcare environment, a faceshield cannot be used as a substitute for a mask,
but instead may be utilized for eye and facial protection from splashes and sprays in
addition to a mask or respirator.]
The Association for the Advancement of Medical Instrumentation (AAMI) also provides
examples of expected use conditions and procedural applications for selecting materials
for gowns based on the required level of barrier protection as outlined in its guideline,
Liquid Barrier Performance and Classification of Protective Apparel and Drapes Intended
for Use in Health Care Facilities (AAMI/ANSI B70).8
See Table 1 for examples of surgical/invasive procedures and the barrier performance
classification levels based on the level of on the anticipated blood and body fluid
exposure.9

Table 1 General Relationships between Barrier Performance and Anticipated

Risks of Exposure*;

Examples of possible barrier performance levels for particular applications.
ANSI/AAMI
PB70
Barrier
Performance
Level 1

Risk of
Exposure:
Fluid Amount
Minimal

Risk of
Exposure:
Fluid spray or
splash
Minimal

Risk of
Exposure:
Pressure on
gown or drape
Minimal

Examples of procedures with

anticipated exposure risks
Simple

excisional biopsies
of lumps and

Excision

bumps

Ophthalmological procedures
Simple

ear, nose, and throat

(ENT) procedures

Level 2

Low

Low

Low

Tonsillectomies

Level 3

Moderate

Moderate

Moderate

Mastectomies

Level 4

High

High

High

Any

and
adenoidectomies
Endoscopic gastrointestinal
procedures
Simple orthopedic
procedures during which
tourniquets are used
Open hernia repair
Minimally invasive surgery
(MIS)
Interventional radiology
or catheter laboratory
procedures
Arthroscopic

orthopedic
procedures
Endoscopic urological
procedures (e.g.,
transurethral prostate
resections [TURP]_
Open gastrointestinal and
genitourinary procedures
procedure in which the
surgeons hands and arms
are in a body cavity
Orthopedic procedures
during which tourniquets are
not used
Open cardiovascular or
thoracic procedures
Trauma procedures
Cesarean sections

* NOTE: The examples listed in this table are not meant to be all-inclusive for every
situation that may be encountered in any health care facility; nor are they a substitute
for professional judgment and experience.

Best Practices: Donning

Sterile gowns should be donned after performing the surgical hand scrub; the hands
and forearms must be completely dry in order to prevent wicking and the transfer of
microorganism through the gown. If using the traditional hand scrub method, the hands
and forearms must be dried with a sterile towel; if an alcohol-hand rub agent is used,
the agent must be completely evaporated before donning the sterile gown. Scrubbed
personnel should don sterile gowns and gloves from a sterile area away from the main
instrument table in order to prevent contamination of the sterile field. The proper steps
for donning a single use wraparound sterile surgical gown that should be taken by the
scrubbed person and circulating nurse is as follows.
Scrubbed person:
o Grasp the sterile gown at the neckline with both hands and lift it out of the
wrapper; move to an area where the gown can be opened fully without the risk
of contamination.
o Allow the gown to unfold, holding it away from the body with the inside facing
the wearer; keep hands on the inside of the gown while it unfolds.
o Slip both hands into the open armholes while keeping the hands at shoulder
level and away from the body.
o Push the hands and forearms into the sleeves of the gown, advancing the
hands only to the proximal edge of the cuff.
Circulating nurse:
o Pull the gown over the scrub persons shoulders, touching on the inner
shoulder and side seams.
o Tie or clasp the neckline; tie the inner waist ties of the gown, touching only
the inner aspect of the gown. The gown should be completely fastened by the
circulating nurse before the scrubbed person dons sterile gloves, in order to
prevent contamination from the gown flapping.
Scrubbed person and circulating nurse:
o After the scrubbed person has donned sterile gloves, he/she hands the tab
attached to the back tie of the gown to the circulating nurse. The scrubbed
person then makes a three-quarters turn to the left while the circulating nurse
extends the back tie to its full length. (This action effectively wraps the back
panel of the gown around the scrub person and covers the previously tied
inner waist ties.) The scrubbed person then carefully retrieves the back tie by
pulling it out of the tab held by the circulating nurse and ties it with the other
tie, which previously had been secured to the front top of the gown.
With reusable gowns, the absence of a tab on the back creates the need for an
alternative procedure for securing the gown. If the wearer is going to use the closed
gloving technique with commercially prepared, double-wrapped sterile gloves, then
the inner glove wrap can be used as a protective extension for the gown tie when the
10

circulating nurse assists with tying a wraparound gown. After donning sterile gloves, the
scrubbed person unties the exterior gown ties (which are tied at the front of the gown prior
to folding, wrapping, and sterilization) and holds both ties in the hands. The end of the back
tie is then placed in the center crease of the empty glove wrapper, about two-thirds of the
way up to the edge of the opened wrapper. The glove wrapper is then closed to conceal
the tie. The scrubbed person then hands the closed wrapper to the circulating nurse,
who firmly grasps the folded edge of the wrapper without touching the tie. The scrubbed
person pivots in the opposite direction from the circulating nurse, who then extends the
back tie to its full length. The scrubbed person grasps the exposed portion of the back
tie, pulls it out of the glove wrapper (while taking care to avoid touching the glove wrapper
or the circulating nurse) and then ties both ties. If a sterile glove wrapper is not available
for use, a sterile hemostat or ringed forceps can be clamped to the back tie and used in
the same manner as the glove wrapper. After the gowning procedure has been completed
the circulating nurse retains the instrument in the OR to avoid any discrepancies with the
subsequent instrument counts.
A scrubbed person who is gowned and gloved may often need to assist another scrubbed
person in donning a sterile gown. The person who is already gowned and gloved grasps
the sterile gown; the inner side with the open armholes is turned toward the individual
who is to be gowned. A cuff is made of the neck and shoulder area of the gown in order
to protect the gloved hands. The gown is held until the persons hands and forearms are
in the sleeves of the gown. The circulating nurse assists in pulling the gown onto the
shoulders, adjusting the back of the gown, and then tying the ties. The wraparound back
on the gown is fixed into position by the scrubbed person after sterile gloves have been
donned.
The sleeves of a gown should be of sufficient length in order to cover the back of the hands
to avoid exposing the gown cuff when the gloves slide down. The sleeve cuffs should be
considered contaminated if the scrubbed persons hands pass beyond the cuff. The cuffs of
the gown should remain at or below the natural wrist area. The gown sleeves should not be
pulled up, leaving the cuffs exposed.
When donning a surgical gown it is important to ensure that all gown ties are adequately
adjusted and that the neck closure provides a secure fit. In addition, perioperative personnel
should take the time to ensure that the gown is donned properly, so that complications with
the gown, and the potential for contamination, do not occur during the procedure.

Best Practices: In-Use

Maintaining the sterile field during a surgical and/or invasive procedures is a key infection
prevention strategy; every attempt must be made toward preventing the invasion of
microorganisms into the surgical wound. Therefore, in order to maintain the sterile field,
parameters for sterility of the surgical gown have been established and must be monitored
during a procedure. The sterility parameters for a surgical gown are as follows:
The front of a sterile gown is considered sterile from the chest to the level of
the sterile field. The rationale for this is because most scrubbed personnel work
adjacent to a sterile bed and/or table.
11

 The sleeves of a gown are considered sterile from two inches above the elbow to
the cuff, circumferentially.
The neckline, shoulders, underarms, sleeve cuffs, and gown back are areas of
friction; they are not considered effective microbial barriers and therefore are not
considered sterile. Additionally, the gown back is not considered sterile because
it cannot be constantly monitored.
Some of the examples of issues that can compromise the integrity of a surgical gown
during a procedure include:
rubbing against operating room (OR) bed or instrument table, creating pressure
and abrasion;
splashes of blood and body fluids on the gown; blood channeling down the glove;
moving the arms, which can cause pilling of the gown material;
moving the arms and hands, which can expose the gown cuff;
difficulty moving the arms because the gown is too tight; and
the active electrosurgery electrode is inadvertently activated against the gown.
At times, the surgical gown may become contaminated during the procedure and need
to be changed; in these situations, both the gown and gloves must be changed. The
following steps should be taken to change contaminated gowns and gloves:
The circulating nurse obtains a sterile gown and gloves for the scrubbed person
needing to change.
The scrubbed person steps away from the sterile field.
The circulating nurse dons protective gloves, and then unties the scrubbed
persons gown at the neck and waist.
The scrubbed person grasps the front of the gown at the shoulders below the
neckline; the gown is pulled off inside out by the wearer and rolled off away from
the body. Alternatively, the circulating nurse turn to face the scrubbed person,
grasp the gown at the shoulders and, while inverting the gown, pull it off.
The gloves are removed next.
Once the gloves are removed, the scrubbed person is ready to regown and
reglove.

Best Practices: Removal

Just as proper donning of sterile attire is important, so is the proper and safe removal
of the contaminated gowns and gloves at the conclusion of a surgical and/or invasive
procedure. To protect the forearms, hands, and scrub attire from coming in contact
with bacteria on the outer side of the used surgical gown and gloves, members of the
scrubbed surgical team should follow the following procedure for removal of soiled gowns
and gloves.
Wipe gloves clean with a wet, sterile towel.
Untie the surgical gown; the circulator should unfasten the back closures.
12

 Grasp the gown at one shoulder seam without touching the scrub attire.
Bring the neck and sleeve of the gown forward, over and off of the gloved hand,
turning the gown inside out and everting the cuff of the glove.
Repeat the above two steps for the other side of the gown.
Keep the arms and gown away from the body while turning the gown inside out;
discard the gown carefully in the designated receptacle.
Using the gloved fingers of one hand to secure the everted cuff, remove the glove
turning it inside out; discard appropriately.
Using the ungloved hand, grasp the fold of the everted cuff of the other glove and
remove the glove, inverting the glove as it is removed; discard appropriately.
After leaving the restricted area, remove the mask by touching the ties or elastic
strap only; discard in the designated receptacle.
Wash hands and forearms.

Summary

Surgical gown materials that serve as microbial barriers are an important link in the
prevention of disease transmission for surgical patients as well as members of the
perioperative team. It is vital that the aseptic environment created for a surgical and/
or invasive procedure is monitored and maintained throughout the procedure. It is
also important that perioperative nurses remain aware of the key characteristics of the
materials used in the manufacture of surgical gowns, and the criteria for surgical gown
selection, including the level of barrier protection needed. In addition, by understanding
and implementing best practices for donning, using, and removing surgical gowns,
perioperative nurses play an integral role in selecting and using surgical gowns
appropriately, thereby providing a safe environment for both their patients and coworkers.

13

Case Study - Gowning Practices

The following case study is presented to allow the learner to synthesize and apply
the concepts discussed in the study guide to workplace scenarios. Read the scenario
carefully, integrating the data and information to discuss the points to consider.

Case Study Whats Wrong with This Picture?

Jean Snyder, RN, CNOR is a staff nurse at Seabreeze Medical Center, a 300 bed
metropolitan hospital. Seabreeze had recently signed an agreement with the medical
school at the metropolitan university; medical students had begun rotating through the
various clinical areas over the last month. Today, Jean is assigned to orthopedic cases
with the hand surgeon Dr. Barber; the first case of the day is an open carpal tunnel
release. Jean has set up the room with the surgical technologist, has interviewed the
first patient, and is conducting a final review of the patients chart. Tom Boyer, RN,
MBA, CNOR, the Director of Surgical Services, approaches Jean in the holding room
to introduce her to Mike Long, a third year medical student who is assigned to the
orthopedic service this quarter and will be scrubbing in to observe Dr. Barbers cases
today.
Jean returns to the OR and assists the surgical technologist in gowning and gloving Mike.
Mike is a rather large individual - Jean estimated he is about 6 feet tall, weighing about
200 pounds; Mike commented that he played football in both high school and college.
Jean stretched the ties at the neck in order to tie the gown, slightly ripping one of the ties;
the back of the gown remains slightly open. Mike stands quietly in the corner of the room
while the patient is being prepped and draped, crossing his arms across his chest, with
his hands under his arms. He is frequently moving his arms and adjusting the sleeves;
one of his gloves rolls down and exposes the gown cuff. Once the patient is prepped
and draped, Jean provides sitting stools for Dr. Barber, the Registered Nurse First
Assistant (RNFA), and Mike around the hand table. During the case, Mike is observing
intently with his elbows resting firmly on the hand table; he comments that he is feeling
somewhat hot under the surgical lights. At the end of the case, Mike removes his gloves,
mask, and tears the gown off while discussed the case with Dr. Barber in the room.
Points to Consider:
What are the issues/problems in this scenario?
What are the appropriate best practices?
Discussion of Points to Consider:
What are the issues/problems in this scenario?
o Break in sterile technique Mike crosses his arms across his chest, with his
hands under his arms.
The underarms of gowns are areas of friction and are not considered
effective microbial barriers and therefore are not considered sterile.
o Improper gown fit - the gown is not of adequate size to fit Mike adequately.
The ties were ripped in order to tie the neck.
14

The back of the gown is not completely closed.

The sleeves are too short; one cuff was exposed when the glove
rolled down, thereby contaminating the gown.

Frequent moving of the gown can cause pilling of the gown material.

His behavior demonstrates that he is uncomfortable in the gown.

The gown does not maintain a comfortable body temperature for

Mike.

o Pressure exerted on the gown by Mike resting his elbows on the table.
The mechanical action of pressure can result in both liquid and dry
penetration of microbes through the gown.

o Improper gown removal.

Mike removes his gloves before removing the gown.

What are the appropriate best practices?

o Recognize and correct breaks in technique:
The gown is considered contaminated after Mike placed his hands
under his arms and the gown cuff was exposed; both gown and
gloves must be changed.

o Ensure that gowns of adequate size are available for all personnel to ensure
comfort and maintenance of body temperature/isothermic environment.
The back of the gown should be completely closed.

The sleeves should be long enough to prevent exposure of the cuff.

o Remove contaminated surgical attire in the proper order:

Remove the gown first, untying the gown with assistance from Jean
in unfastening the back closures.

Keep the arms and body of the gown away from the body; turn
the gown inside out; discard the gown carefully in the designated
receptacle.

Remove gloves last, inverting the gloves to prevent contamination;

discard gloves appropriately.

Remove the mask outside of the OR.

o Jean should also discuss this scenario with Tom to develop and implement an
education plan for the medical students regarding aseptic technique, gowning
and gloving procedures prior to their OR rotation.

15

GLOSSARY
Barrier

A physical or mechanical obstacle between

a person and a hazardous substance or
microorganism.

Barrier Material

Material that minimizes or retards the penetration of

microorganisms, particulates, and fluids.

Bloodborne Pathogens

Pathogenic microorganisms that are present

in human blood and can cause disease in
humans. These pathogens include, but are not
limited to, hepatitis B virus (HBV) and human
immunodeficiency virus (HIV).

Contaminated

The presence or the reasonably anticipated

presence of blood or other potentially infectious
materials on an item or surface.

Everted

Same as inversion: the act of turning inside out

Exposure Incident

A specific eye, mouth, other mucous membrane,

non-intact skin, or parenteral contact with blood or
other potentially infectious materials that results
from the performance of an employees duties.

Gowning

Applying a sterile gown to oneself or other

members of the sterile surgical team.

Isothermic Environment

The surroundings, conditions, or influences that

affect maintaining an equal temperature.

Nonwoven Material

A manufactured sheet, web, or batt of directionally

or randomly oriented fibers or filaments, natural
or man-made, excluding paper and paper
products, which are woven, knotted, tufted, or
stitch bonded and have not been converted into
yarns. Nonwoven materials are bonded to each
other by friction and/or adhesion and/or cohesion.
Nonwovens are designed as single-use materials.

Occupational Exposure

Reasonably anticipated skin, eye, mucous

membrane, or parenteral contact with blood or
other potentially infectious materials that may result
from the performance of an employees duties.

16

Personal Protective Equipment

Protective equipment (e.g., masks, gloves,

goggles, face shields, and gowns) for eyes,
face, head, and extremities; protective clothing;
respiratory devices; and protective shields and
barriers designed to protect the wearer from
injury.

Scrub Attire

Additional sterile clothing worn to cover the

surgical attire to present sterile boundaries during
a sterile invasive procedure.

Strike-through

Contamination of a sterile surface by moisture

that has originated from a non-sterile surface and
penetrated the protective covering of the sterile
item.

Surgical Attire

Nonsterile apparel designated for the

perioperative practice setting that includes twopiece pantsuits, cover jackets, head coverings,
shoes, masks, protective eyewear, etc. and other
protective barriers.

Wicking

Absorption of liquid by capillary action along a

thread or through the material.

Woven Material

Fabric constructed from yarns made of natural

or synthetic fibers or filaments that are woven
together to form a web in a repeated interlocking
pattern.

17

REFERENCES / SUGGESTED READINGS

1.

AORN. Guideline for sterile technique. Guidelines for Perioperative Practice.

Denver, CO; AORN, Inc; 2015: 67-95.

2.

CDC. Considerations for selecting protective clothing used in healthcare for

protection against microorganisms in blood and body fluids. http://www.cdc.gov/
niosh/npptl/topics/protectiveclothing/. Accessed September 23, 2015.

3.

Phillips N. Appropriate attire, surgical hand cleansing, gowning and gloving. In

Berry & Kohns Operating Room Technique, 12th ed. St. Louis, MO: Mosby Elsevier;
2013:267-284.

4.

Spry C. Infection prevention and control. In Alexanders Care of the Patient in

Surgery, 15th ed. St. Louis, MO: Mosby Elsevier; 2015:69-123.

5.

Moss R. Aseptic technique. Competency Assessment Module. Denver, CO:

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