What is the difference between surgical and isolation gowns?

In the past few years, as Covid-19 spread across the world, the PPE (Personal Protective Equipment) started to fly off the shelves. It became the hottest topic in the healthcare industry and the demand rose. As it is with every product, demand means supply too. The question of quality also arose in the wake of the pandemic. And a whole new breed of suppliers cropped up vying for the sudden requirement in the healthcare industry. Alongside this came a whole lot of relatable questions on the types of PPE suits and the level of protection each gave. The biggest question is what was the difference between disposable surgical gowns and disposable isolation gowns.

Isolation gowns are used to protect healthcare workers and patients from contamination of bodily fluids and micro-organisms; whereas surgical gowns are the kind of apparel that is to be worn inside the OT (Operation Theatre) during surgeries to protect the wearer as well as the patient from transfers of particulate material, bodily fluids and micro-organisms.

Medical gowns are classified depending on how much it can safeguard against contamination. It is a given that the wearer will be exposed to bodily fluids and microorganisms that can be potentially infectious. This is where the level of protection of the gowns comes into play. DCGI (Drug Controller General of India) within the CDSCO (Central Drugs Standard Control Organisation) has set standards for the quality control that each healthcare product must pass through. There are strict testing procedures and these determine the effectiveness of the products and thus ensure maximum safety for the healthcare worker and the patient.

The four strata of barrier protection are:
1.Minimum risk level - The level of barrier protection is low and hence they should be used only when there is very little risk of exposure to bodily fluids. Like visiting doctors and nurses, and during non-invasive procedures or regular check-ups.
2. Low risk level - These are better at barrier protection than the earlier one, and splashes or splatters of liquid would give better results in barrier protection. Ideal for ICU visits or intravenous blood transfusions and withdrawal of blood.
3. Moderate risk level - These come with good barrier protection and work well at medical scenarios with moderate risk such as ER (Emergency Rooms) and invasive procedures like arterial withdrawals of blood and IV (Intravenous) lines insertions. Efficacy against blood splatters and soakage of liquids is ensured by running appropriate tests.
4. High risk level - This is for high risk scenarios and has to have the highest level of barrier protection efficacy. These are meant for fluid intensive procedures such as surgeries. These heavy-duty gowns work for all four barriers and won’t let any bacterial pathogens or body fluids penetrate through the material barrier. To check the effectiveness, these undergo strict testing and simulated blood is used as part of the testing procedure. When a pandemic breaks out, the risk of infection and contamination runs high, and in this situation, the maximum precaution has to be taken. At such times, such gowns come into play as the barrier protection is high against these communicable diseases.

Factors of disposable isolation gowns versus disposable medical gowns

CDSCO (Central Drugs Standard Control Organisation) under DGHS (Directorate General of Health Services) is the equivalent of FDA (Food and Drug Administration)in India. A surgical gown is a Class II medical device and it has to receive a premarket notification of 510(k) before distribution.

As we all know, surgeries are exceedingly meticulous and well-governed procedures that have high sanitation standards. This makes all the medical gowns suitable for all the risk levels, more or less.

Surgical gowns are neatly labeled making them easily identifiable to suit their purpose. The distinguishing feature of a surgical gown is the protection zone that is crucial. These zones are the identifiable areas of a gown that are vulnerable to the transmission of harmful pathogens and bacteria during a procedure. The basic disposable Surgical Gowns have standard protection zones based on the frontal part, primarily. These zones are critical and are the main difference between surgical and isolation gowns. The barrier protection necessitates the disparity; while in isolation gowns, the entire garment is considered for barrier protection, in surgical gowns, only the impact areas are considered.

Choosing the correct gown for the correct procedure is imperative. The surgical gown manufacturers in India are a lobby that works relentlessly to ensure maximised safety measures. A healthcare facility has the decision-making power on what kinds to choose from and for what procedures. This all depends on the risk levels and which provider is preferred. Although it all boils down to what are the levels of barrier protection. The assigned procedures should be protected suitably as well as the purpose achieved.

Polyethylene and polypropylene are two kinds of disposable medical gowns that are high on many healthcare facilities’ lists. Mainly, due to the lesser risk of contamination it provides. Reusable gowns are made using cotton or synthetic fabrics while synthetic gowns are made for people suffering from allergies and hence, are latex-free.

Also, size matters here as an oversized or an undersized gown can expose one to contamination or obstruction during a surgery or a medical procedure.

Conclusion

Careful consideration has to be put into choosing what is right for your medical facility, because it impacts the health and safety of your healthcare professionals, patients and personnel.

Take care of the patient and everything else will follow.
-Thomas Frist, M.D.