A sterile gown is a specialized piece of personal protective equipment (PPE) worn in environments where preventing contamination is critical, such as operating rooms or certain laboratory settings. These gowns create a barrier, protecting both the wearer from contaminants and the sensitive environment from microorganisms. They are essential for maintaining a sterile field, an area kept free of all living microorganisms.
Why Sterile Gowning is Crucial
Maintaining sterility is crucial in environments like healthcare settings to prevent the introduction of harmful microorganisms. Without proper sterile gowning, there is a substantial risk of transmitting bacteria and other pathogens, potentially leading to patient infections. These healthcare-associated infections can cause significant health complications and prolong recovery times.
A sterile gown acts as a physical barrier, minimizing the transfer of microorganisms from the wearer’s skin and clothing to the sterile field. This protection extends both ways, safeguarding the wearer from exposure to blood or bodily fluids, and shielding the patient from external contaminants. This barrier is vital for surgical procedures and other invasive medical interventions where infection risk is elevated.
Beyond healthcare, sterile gowning is equally important in controlled environments like pharmaceutical manufacturing or research laboratories. In these settings, even microscopic contamination can compromise experimental results, affect product quality, or lead to hazardous outcomes. Adherence to sterile gowning protocols helps uphold the integrity of sensitive processes and protects personnel from hazardous substances.
Preparing for Sterile Attire
Proper preparation is necessary before donning sterile attire to maintain a sterile field. This process begins with thorough hand hygiene, typically a surgical scrub, involving washing hands and forearms with antimicrobial soap and water. The scrub aims to significantly reduce skin microbial count, though complete sterilization is not achievable.
During the surgical scrub, clean under fingernails and scrub all surfaces of hands and fingers for a specified duration. Keep hands elevated above elbows during rinsing to allow water to flow from cleanest to less clean areas, preventing recontamination. After scrubbing, dry hands and forearms completely with a sterile towel.
Before touching the gown, remove all jewelry from hands and wrists. The workspace for opening the gown should be clear and organized, ideally a clean, flat surface. Inspect the sterile gown’s packaging for any signs of damage, tears, or moisture to confirm its sterility before opening.
The Sterile Gowning Process
Once preparations are complete, open the sterile gown package on a clean, dry surface, touching only the outer wrapper. Carefully lift the gown by grasping the inside of the neckband. Step away from sterile tables or non-sterile surfaces as the gown unfolds, avoiding floor contact.
Hold the gown by the shoulder seams and insert arms into the sleeves, keeping hands within the gown cuffs. Hands must remain completely inside the sleeves, never protruding through the cuffs. This technique, known as closed gloving, is essential for maintaining sterility as it prevents bare hands from touching the outside of sterile gloves.
A non-sterile assistant then pulls the gown over the shoulders and secures the neck and back ties. If no assistant is available, some gowns feature self-tying mechanisms. With hands still enclosed within the gown sleeves, open the sterile glove package onto a sterile surface.
Pick up the first glove by its folded cuff edge and place it palm-down on the opposite gown sleeve. Stretch the glove cuff over the hand, completely covering the gown cuff, and slide fingers into the glove. Repeat for the other hand using the now-gloved hand to assist. After both gloves are donned, make minor adjustments for a comfortable and secure fit, ensuring gown cuffs remain fully covered by glove cuffs. The gown’s waist tie, if not secured by an assistant, can then be tied, allowing the wearer to secure it without contamination.
Post-Gowning Conduct and Safe Removal
Once sterile gown and gloves are on, maintaining sterility is a continuous responsibility. Individuals in sterile attire should keep hands and arms within the sterile field, typically above the waist, below the shoulders, and in front of the body. The front of the gown from chest to waist level and the sleeves from mid-arm to the cuff are considered sterile.
Movement within the sterile environment should be deliberate and controlled, avoiding unnecessary turns or contact with non-sterile surfaces or personnel. Sterile team members should always face the sterile field and other sterile individuals when moving around. If any part of the sterile gown or gloves touches a non-sterile surface, it is considered contaminated and must be changed immediately.
When the procedure is complete, safe removal of the gown and gloves, known as doffing, is important to prevent self-contamination and the spread of microorganisms. The gown’s waist ties are typically broken, and the gown is pulled away from the body, rolling it inside out as it is removed. This action contains any external contaminants within the gown.
Gloves are often removed simultaneously with the gown, peeling them off inside out as the gown is bundled. If gloves do not come off with the gown, remove them using a “glove-to-glove, skin-to-skin” technique: one gloved hand pulls off the other glove, then the ungloved hand removes the remaining glove from the inside. After removal, dispose of the gown and gloves in appropriate waste receptacles, and perform thorough hand hygiene immediately.