Laundering and Laundering and Restoration of Reusable Restoration of Reusable Surgical Barrier TextilesSurgical Barrier Textiles
Steven J. TinkerSteven J. TinkerDirector, Research & DevelopmentDirector, Research & Development
Gurtler Industries, Inc.Gurtler Industries, Inc.
Reusable Surgical TextilesReusable Surgical Textiles
Barrier Surgical Gowns and Drapes - Barrier Surgical Gowns and Drapes - Fluid Resistant TextilesFluid Resistant Textiles Protect health care workers from Protect health care workers from
blood and bodily fluidsblood and bodily fluids Provide comfort and allow for Provide comfort and allow for
sterilizationsterilization Several degrees of protection Several degrees of protection
availableavailable
Fabric TechnologyFabric Technology MuslinMuslin
Traditional reusable OR fabricTraditional reusable OR fabric Poly/Cotton BlendPoly/Cotton Blend
Repellent finishesRepellent finishes Polyester Microfiber TechnologyPolyester Microfiber Technology
Continuous filament threadsContinuous filament threads Tightly wovenTightly woven Repellent finishesRepellent finishes
Reusable Surgical TextilesReusable Surgical Textiles
MuslinMuslin
Reusable Surgical TextilesReusable Surgical Textiles
Cotton/polyester blendsCotton/polyester blends
Reusable Surgical TextilesReusable Surgical Textiles
100% polyester ‘microfiber’100% polyester ‘microfiber’
Reusable Surgical TextilesReusable Surgical Textiles
Laminated fabrics – Gore-TexLaminated fabrics – Gore-Tex®®
Reusable Surgical Textiles Reusable Surgical Textiles
Microfiber TechnologyMicrofiber Technology
Continuous filaments vs. staple fibersContinuous filaments vs. staple fibers Significantly lower linting potentialSignificantly lower linting potential
Fluid Repellent FinishesFluid Repellent Finishes
Polyester is “naturally” hydrophobicPolyester is “naturally” hydrophobic But highly oleophilicBut highly oleophilic
FluoropolymersFluoropolymers Water and oil repellentWater and oil repellent Mill applied, curedMill applied, cured
Environmental IssuesEnvironmental Issues
Reusable Surgical Textiles can reduce Reusable Surgical Textiles can reduce medical waste significantlymedical waste significantly One garment can replace 150-200 One garment can replace 150-200
disposable gownsdisposable gowns Considerable medical waste Considerable medical waste
incineration or landfill impactincineration or landfill impact Significant cost savings can be Significant cost savings can be
achievedachieved
Environmental IssuesEnvironmental Issues
AHA & EPA agreement: Hospitals for a AHA & EPA agreement: Hospitals for a Healthy EnvironmentHealthy Environment Goals: Reduce the overall volume of Goals: Reduce the overall volume of
hospital waste (both regulated and hospital waste (both regulated and non-regulated waste) bynon-regulated waste) by 33 percent by 2005 and 33 percent by 2005 and 50 percent by 2010 50 percent by 2010
See www.h2e.orgSee www.h2e.org
Regulatory IssuesRegulatory Issues
Surgical gowns, drapes wraps and Surgical gowns, drapes wraps and towels are “Class II Medical Devices” as towels are “Class II Medical Devices” as defined by FDAdefined by FDA
Commercial laundries that reprocess Commercial laundries that reprocess surgical textiles may need to register surgical textiles may need to register with FDAwith FDA
Reporting Requirements –Reporting Requirements – Strike-throughStrike-through Complaint handlingComplaint handling
Standard Laundry ProcessStandard Laundry Process TimeTime
30-45 minutes30-45 minutes TemperatureTemperature
160-180°F160-180°F Mechanical ActionMechanical Action
Rated Capacity of WasherRated Capacity of Washer Chemical ActionChemical Action
pH 11.0-11.5pH 11.0-11.5 Surface Active AgentsSurface Active Agents
Standard Laundry Process
Temperature Time
Chemical Action
Mechanical Action
Reusable Care ConcernsReusable Care Concerns
Low absorptivityLow absorptivity Laminated fabrics: Impervious to fluid Laminated fabrics: Impervious to fluid
transmissiontransmission Barriers reduce chemical Barriers reduce chemical
transmission through fabrictransmission through fabric Reduced soil removal efficacyReduced soil removal efficacy
Reusable Care ConcernsReusable Care Concerns
Polyester - affinity to oily soilsPolyester - affinity to oily soils Recommended temperature between Recommended temperature between
140-160140-160°F°F Use nonionic detergents – more Use nonionic detergents – more
difficult to rinsedifficult to rinse
Reusable Care ConcernsReusable Care Concerns
Rinsing of detergent is key to barrier Rinsing of detergent is key to barrier performanceperformance Any residual detergent will affect Any residual detergent will affect
barrier performance negativelybarrier performance negatively Must add extra rinsing time and stepsMust add extra rinsing time and steps No fabric softeners or anti-static No fabric softeners or anti-static
agents can be usedagents can be used
Reusable Care ConcernsReusable Care Concerns
Polyester - Alkaline hydrolysis potentialPolyester - Alkaline hydrolysis potential Reduce the amount of alkali, Reduce the amount of alkali,
reduce pH to <10.5reduce pH to <10.5 Keep temperature <180Keep temperature <180°F°F
Soil CharacteristicsSoil Characteristics
Blood SoilsBlood Soils Low temperature flushes to reduce “setting”Low temperature flushes to reduce “setting” Enzyme detergent in prewash zone of tunnelsEnzyme detergent in prewash zone of tunnels
Soil CharacteristicsSoil Characteristics
Oily Soils – Body Oils or Mineral OilsOily Soils – Body Oils or Mineral Oils Polyester has a high affinity for these soilsPolyester has a high affinity for these soils High surfactant detergents with oily soil High surfactant detergents with oily soil
emulsification propertiesemulsification properties Cloud point of detergent 100-120Cloud point of detergent 100-120°F°F High phosphate detergents work betterHigh phosphate detergents work better Solvent-based detergent additives can helpSolvent-based detergent additives can help
Soil CharacteristicsSoil Characteristics
Tape ResidueTape Residue Use special tape with water/alkali soluble Use special tape with water/alkali soluble
adhesiveadhesive Very difficult – if the wrong tape is usedVery difficult – if the wrong tape is used Solvent detergent re-washes, high Solvent detergent re-washes, high
temperature reclaim processtemperature reclaim process
Reusable Care ConcernsReusable Care Concerns
Fluoropolymer finishes: Can be Fluoropolymer finishes: Can be removed with harsh laundering removed with harsh laundering processesprocesses Reduce alkaliReduce alkali Avoid use of oxalic acidAvoid use of oxalic acid Avoid some harsh solventsAvoid some harsh solvents
Barrier Fabric ProcessBarrier Fabric Process Increased TimeIncreased Time
45-60 minutes45-60 minutes Reduced TemperatureReduced Temperature
140-160140-160°F°F Increase Mechanical ActionIncrease Mechanical Action
65-75% of rated capacity65-75% of rated capacity Change Chemical RatiosChange Chemical Ratios
More detergent, less alkaliMore detergent, less alkali
Barrier Fabric Process
Mechanical ActionChemical
Action
Temperature
Time
Drying ProcessDrying Process
Achieve “bone-dry” stateAchieve “bone-dry” state Dry at 170-200Dry at 170-200°F°F Maintain maximum temperature for Maintain maximum temperature for
3-5 minutes3-5 minutes Cool-down to 100°FCool-down to 100°F
Reusable ProtectionReusable Protection
Suter test - Hydrostatic resistanceSuter test - Hydrostatic resistance AATCC 127-1985AATCC 127-1985
Oil and water repellency testsOil and water repellency tests AATCC 118-1992AATCC 118-1992
Resistance of Protective Clothing Materials to Resistance of Protective Clothing Materials to penetration by blood or bloodborne pathogenspenetration by blood or bloodborne pathogens ASTM F1670-95ASTM F1670-95 ASTM F2671-95ASTM F2671-95
Repellency PerformanceRepellency Performance
Oil Repellency is a major issue in Oil Repellency is a major issue in surgical protective barrier materialssurgical protective barrier materials Suter test doesn’t reflect oil Suter test doesn’t reflect oil
repellency performancerepellency performance Oil stains can cause concern with Oil stains can cause concern with
health care personnelhealth care personnel
Repellency Performance
0
10
20
3040
50
60
70
80
0 25 50 75 100 125 150
Number of Cycles
Hyd
rost
atic
Rat
ing
, c
m
Barrier RejuvenationBarrier Rejuvenation
Modified fluoropolymers can be added Modified fluoropolymers can be added in the final rinse cyclein the final rinse cycle Use rate of 2-6 oz/cwtUse rate of 2-6 oz/cwt Cost of 2-4 cents per garmentCost of 2-4 cents per garment Good drying is critical Good drying is critical
““Maintenance” application of polymer Maintenance” application of polymer can extend life beyond 150-200 uses can extend life beyond 150-200 uses
ReferenceReference
ANSI/AAMI ST65:2000 – ANSI/AAMI ST65:2000 –
Processing of reusable surgical textiles Processing of reusable surgical textiles for use in health care facilitiesfor use in health care facilities
ANSI/AAMI PB70:2003 –ANSI/AAMI PB70:2003 –
Liquid barrier performance and Liquid barrier performance and classification of protective apparel and classification of protective apparel and drapes in health care facilities.drapes in health care facilities.
Additional SourcesAdditional Sources
ARTA - American ARTA - American Reusable Textile Reusable Textile AssociationAssociation www.arta1.comwww.arta1.com
TRSA – Textile TRSA – Textile Rental Services Rental Services AssociationAssociation www.trsa.orgwww.trsa.org
Laundering and Laundering and Restoration of Reusable Restoration of Reusable Surgical Barrier TextilesSurgical Barrier Textiles
Steven J. TinkerSteven J. [email protected]@gurtler.com