Disposable versus reusable medical gowns: A performance comparison, by Meredith McQuerry, PhD, Elizabeth Easter, PhD, and Alex Cao, BSc

A major challenge of the CDC's recommendation to adopt reusable gowns during surge capacity is that cloth gowns have a much lower market share than disposable gowns in US health care. Presently, disposable gowns make up at least 80% of the isolation gown market (Jenkins, 2018). However, this market share trend is expected to change over time in favor of reusable gowns. Especially as the protection of disposable gowns has been called into question after recent epidemics such as the Ebola crisis of 2014 which claimed the lives of over 11,000 people, including 500 health care personnel. Following this crisis, in 2016 it was found that some medical gowns on the market were defective, allowing fluids to leak through, ultimately infecting surgeons and nurses in contact with infected patients.

Previous research has highlighted the sustainability of reusable gowns noting they are more cost-effective throughout their life cycle in terms of production costs, waste, and carbon footprints. Limited studies, however, have been conducted on the required protective performance and durability of reusable surgical gowns over their useful life, specifically across the wash lifespan. Leonas (1998) assessed the barrier properties of reusable gowns after 50 commercial care cycles and found that laundering reduced the ability of the fabric to prevent the transmission of bacteria. Higher barrier properties were found to correspond with higher degrees of repellency and greater fabric thickness (ie, 2-layers in some cases). Besides this study, little research has been performed on reusable gowns after multiple commercial launderings, especially in regard to serviceability components beyond protection, including comfort, durability, and appearance retention. In addition, to the researchers’ knowledge, no study has conducted a comprehensive performance comparison between disposable and reusable gowns across the wash lifespan.

The purpose of this research was to determine the performance of disposable versus reusable medical gowns by assessing their ability to provide adequate protection, durability, and comfort across the product's wash lifespan. First and foremost, the ability of the gowns to meet required protection specifications per AAMI standards was investigated. Commercially available Level 1, 2, and 3 disposable and Level 2 and 3 reusable gowns were evaluated using the American Association of Textile Chemists and Colorists (AATCC) Test Method (TM) 127 and AATCC TM 42. Results were compared to AAMI PB70 and the American Society for Testing and Materials (ASTM) performance requirements. The fabric weight, thickness, breaking strength, tearing strength, seam strength, pilling resistance, dimensional stability, colorfastness, air permeability, and fabric hand of the disposable and reusable gowns were also determined and compared.