Disposable Versus Reusable Medical Gowns: A Performance Comparison
Background
Medical gowns are essential personal protective equipment (PPE) that prevents the spread of microorganisms and bodily fluids. During surge capacity situations, such as the COVID-19 pandemic, reusable PPE is often recommended due to shortages.
Methods
This research evaluated the performance of disposable versus reusable medical gowns by assessing their ability to provide adequate protection across their expected service lifespan. Level I, II, and III gowns were tested for water resistance and hydrostatic pressure, along with other durability assessments (breaking, tear, and seam strength, pilling resistance, dimensional stability, and air permeability, colorfastness, and fabric hand) per standard test methods. Data were collected at new for the disposable gowns and after 1, 25, 50, and 75 industrial launderings for the reusable gowns. Results were compared to the Association of the Advancement Instrumentation® (AAMI) PB70 performance specifications.
Results
Level I and II disposable gowns did not meet AAMI performance specifications for impact penetration water resistance. All 3 levels of disposable gowns also failed to meet the American Society for Testing and Materials performance requirements for breaking strength in the crosswise direction.
Conclusions
The adoption of reusable gowns may result in increased protection and significant cost savings due to their superior durability and sustainability when compared to disposable gowns.
Previous studies make the undeniable argument that reusable gowns are superior from an environmental perspective. This study aimed to assess this argument from a performance standpoint. Overall findings determined that some disposable gowns on the market today are still not meeting AAMI PB70 performance requirements for HCW protection, even after the Ebola crisis of 2014 brought this issue to light. Also, industrial laundering did not have a detrimental effect on the reusable gowns for any measured performance parameter. Therefore, while previous studies have concluded that reusable medical gowns provide significant cost savings from an environmental standpoint, the findings of this study support their superior protection and performance. The largest drawback preventing greater adoption of reusable gowns is their lack of wearer comfort during longer duration surgical settings.
Limitations of this research include sample size, which was limited to one supplier per protection level for the disposable gowns and 2 suppliers per protection level for the reusable gowns. Further, L4 gowns were not included in this study due to measurement equipment limitations. In addition, conditions of use and sterilization between laundering cycles could not be replicated or conducted within this study's scope. Future studies should include all levels of AAMI gowns, and protection from bloodborne pathogens should be evaluated for both disposable and reusable gowns. Reusable gowns should be evaluated for bloodborne pathogen penetration after multiple wash/dry cycles, including sterilization between each cycle. The representation of various material technologies available in both types of medical gowns should also be explored. Future studies should expand the sample size, protection levels, and material variety to include greater representation of the overall medical gown market.
