Effects of patching on sterilization of surgical textiles

Abstract

V W Greene Gwen M Borlaug Evan Nelson he development of nonwoven, disposable surgical gowns, T drapes, and wrappers has generated a controversy in the hospital supply industry, which has spread to the OR nursing profession and hospital central service managers. Some advocate the continued use of woven, reusable fabrics, while others think that the nonwoven products are superior. The controversy is based on the ability of OR textiles to meet three criteria: 0 Ability to be sterilized. Steam or ethylene oxide must be able to penetrate the material to permit complete sterilization of the textile and items and devices included in the pack. Barrier properties. The materials must act as an absolute barrier to microorganisms and dust particles. Wrappers must be resistant to moisture and mechanical injury, such as tearing or puncturing, to maintain sterile integrity of the pack’s interior after removal from the sterilizer. Economy. The per-unit cost of each item must be as low as possible. Disposables have been advocated because, after their initial cost, there is no further expenditure for laundry, patching, and repair. On the other hand, reusables cost more initially, but with each use, the per-unit cost decreases. If the fabrics are torn or punctured during their use, however, they lose their barrier quality, their life expectancy is shortened, and their economic advantage is diminished. To extend the life of woven fabrics and minimize replacement cost, holes are repaired with heat-sealed fabric patches. Do these patches interfere with sterilization? What is the maximum number of patches that may be used to repair a punctured or torn fabric, and where should they be placed? Current guidelines are based more on feelings about safety and esthetics than on scientific data.