Surgical Gowning Technique: Are We Contaminated Before We Cut?. Issue 2 (February 2019)

• Record Type: Journal Article
• Authors: Panas, Kenton; Wojcik, Jonathan; Falcon, Spencer; Hollabaugh, Kimberly; Hickerson, Lindsay E.
• Is Part Of: Journal of orthopaedic trauma. Volume 33:Issue 2(2019)
• Publication Date: 2019-02
• Subjects: surgeon -- surgery -- surgical gowning -- surgical -- gowning -- surgical gown -- gown -- gowning process -- gowning technique -- sterile -- sterility -- technique -- contamination -- contaminate -- operating room; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000001357
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To assess possible breaches of sterility during the initial gowning step. Design: Observational study. Twenty-seven gowning events were monitored for contamination during a simulated two-person gowning process in which a surgical technician assists a surgeon in the gowning process at the beginning of a surgical procedure. The lower portion of the technician's gown was coated with resin powder before the gowning process to simulate contamination. Setting: Single-institution Level 1 trauma center. Participants: Three physicians and 3 tenured surgical technicians. Intervention: Observed contaminated areas represented by ultraviolet resin powder under ultraviolet light on the gown of the surgeon after the two-person gowning step. Main Outcome Measurement: Number and surface area of contamination events. Results: There was a 66.67% rate of contamination of the surgeon's gown sleeves while being gowned by a surgical technician. The overall median contamination for the short surgeon was 1.3 cm 2 . For the medium height surgeon, the overall median contamination was 1.4 cm 2 . The tall surgeon had an overall median contamination of 2.9 cm 2 . Of the short, medium, and tall surgeons, the number of contamination events was 6, 5, and 7, respectively. The study suggested that the surgeon's height was a significant source of variation ( P = 0.046). Conclusion: We present an observational pilot study that suggests that to reduce contamination in the operating room, the two-person method must be highly monitored. This study also proposes that the single-person gowning technique should be used to reduce contamination rate during the gowning process. Abstract : Supplemental Digital Content is Available in the Text.