The relationship of s e l e c t e d fabric

c h a r a c t e r i s t i c s and the barrier

e f f e c t i v e n e s s of surgical gown fabrics
Karen K. Leonas, P h D a
Renita S. Jinkins, P h D b
Athens and Atlanta, Georgia

Background: Relationships between selected fabric characteristics and the barrier

effectiveness of surgical gown fabrics to liquid strike-through and bacterial transmission
were examined.
Methods: Eight commercially available surgical gowns were evaluated in this study. Five of
the gowns were disposable and were produced from nonwoven fabrics. Three of the gowns
were reusable and were produced from woven fabrics. Standard test methods were used to
evaluate the fabrics. Fabric characteristics evaluated included thickness, weight, pore size,
and oil and water repellency. Yarn count was determined for the woven fabrics to establish
the number of yarns per inch in both the warp (lengthwise) and fill (crosswise) fabric
direction. Resistance of the fabrics to the penetration of microorganism suspensions under
a hydrostatic pressure was determined. Microorganisms used in this study were
Escherichia coli and Staphylococcus aureus. Scanning electron micrographs are presented
to illustrate differences among fabrics.
Results: Results of this study showed that fabric characteristics of construction, repellency,
and pore size contributed to gown performance. Liquid strike-through was not always
accompanied by bacterial transmission.
Conclusions: Higher fabric repellency ratings and smaller pore size generally corresponded
with higher barrier properties. (AJIC Am J Infect Control 1997;25:16-23)

T h e t r a n s f e r e n c e of p a t h o g e n s t h r o u g h b o d y
fluids r e c e n t l y h a s r e c e i v e d m u c h a t t e n t i o n . T h e
Occupational Safety and Health Administration,
Centers for Disease Control and Prevention, and
the A s s o c i a t i o n of O p e r a t i n g R o o m N u r s e s h a v e
p u b l i s h e d g u i d e l i n e s to h e l p h e a l t h c a r e w o r k e r s
r e d u c e t h e i r r i s k of o c c u p a t i o n a l e x p o s u r e . 1-3 A
k e y f a c t o r in t h e s e r e c o m m e n d a t i o n s is the u s e of
p r o t e c t i v e s u r g i c a l a p p a r e l as a b a r r i e r to m i c r o -
bial transfer. T h e b a r r i e r p r o p e r t i e s of t h e f a b r i c s
a r e d e t e r m i n e d b y f a b r i c c h a r a c t e r i s t i c s , the b a c -
From the University of Georgia,a Athens, Georgia, and Amoco
Fabrics and Fibers Companyp Atlanta.
Supported by Kimberly-Clark Corporation, Professional Health
Care.
Reprint requests: Karen K. Leonas, PhD, 314 Dawson Hall, The
University of Georgia, Athens, GA 30602.
Copyright © 1997 by the Association for Professionals in Infection
Control and Epidemiology, Inc.
0196-6553/97 $5.00 + 0 17146174303
teria, a n d c h a r a c t e r i s t i c s of the b a c t e r i a - c o n t a i n -
ing fluid.
B a c t e r i a a r e b e l i e v e d to b e t r a n s p o r t e d f r o m
o n e l o c a t i o n to a n o t h e r b y c a r r i e r s s u c h as d u s t or
liquids. 4,s I n the o p e r a t i n g theater, fluids s u c h as
blood, p e r s p i r a t i o n , a n d a l c o h o l act a s c a r r i e r s
t r a n s p o r t i n g t h e b a c t e r i a t h r o u g h t h e fabric.
S m a l l p a r t i c l e s s u c h as skin cells a n d lint also m a y
a c t as carriers. 6,7 T h e r e f o r e o n e m u s t c o n s i d e r the
b a r r i e r fabric's effectiveness in p r e v e n t i n g t r a n s -
m i s s i o n of the c a r r i e r a n d of t h e b a c t e r i a .
M a n y studies h a v e b e e n c o n d u c t e d in the labo-
r a t o r y a n d in the o p e r a t i n g r o o m to e v a l u a t e the
effectiveness of v a r i o u s s u r g i c a l g o w n s as b a r r i e r s
to m i c r o b i a l t r a n s m i s s i o n ¢ ,s-ll Little a t t e n t i o n h a s
b e e n given to specific c h a r a c t e r i s t i c s o f t h e f a b r i c
in the g o w n . T h e r e is a n e e d to m o r e specifically
i d e n t i f y the f a b r i c p a r a m e t e r s t h a t c o n t r o l t r a n s -
m i s s i o n . R e s e a r c h e r s h a v e identified f a b r i c c o n -
s t r u c t i o n a n d r e p e l l e n c y as critical c h a r a c t e r i s -
tics, 5,8,9 b u t f e w details a b o u t t h e s e c h a r a c t e r i s t i c s
have been addressed. In addition, other fabric
c h a r a c t e r i s t i c s k n o w n to i n f l u e n c e b a r r i e r p r o p e r -

16
AJIC
Volume25, Number 1 Leonas and Jinkins 17

Table 1. Gowns evaluated

Fabrics

Code Manufacturer Gown Fiber Construction

A Kimberly-Clark Evolution Fabric 90012-60 polypropylene Nonwoven

B Kimberly-Ciark Evolution Fabric 90112-60* polypropylene Nonwoven
C Baxter Convertors Optima Fabric 9515 wood pulp/polyester Nonwoven
D Baxter Convertors Optima Fabric 9511" wood pulp/polyester Nonwoven
E Boundary Health Care Products Boundary Cool Zone, GLOS wood pulp/polyester Nonwoven
F Angelica Uniform Group, ASEP 100% polyester Woven
St. Louis, Mo.
G Standard Textile, Cincinnati, Ohio Compel* 100% polyester Woven
H Fashion Seal, Seminole, Fla. Fashion SeN 50/50-cotton/polyester Woven

*Fabric reinforced.

Table 2. Woven fabric characterization

Fabric count (yarns per inch) Yarn size (denier)

Fabric Direction Mean SD Direction Mean SD

F Warp 84 1.3 Warp 76 1.3

Fill 92 0.0 Fill 80 0.7
G (Layer 1) Warp 84 2.3 Warp 80 1.1
Fill 76 1.3 Fill 87 2.4
(Layer 2) Warp 84 1.3 Warp 81 2.5
Fill 76 2.3 Fill 85 1.9
H Warp 96 3.8 Warp 144 5.9
Fill 53 1.9 Fill 152 7.2

ties, such as pore size and filament/yarn size, have
not been previously examined.
The primary objective of this study was to mea-
sure characteristics of surgical gown fabrics
believed to be significant in fabrics' effectiveness
as a liquid and bacterial barrier. Scanning elec-
tron micrographs are presented to illustrate dif-
ferences among fabrics.
METHODS
Eight commercially available surgical gowns
were studied (Table 1) . Five of the gowns were
disposable and were produced from nonwoven
fabrics (A to E). Three of the gowns were reusable
and were produced from woven fabrics (F to H).
The reusable gowns were new and had not been
previously laundered. Fabric samples for testing
were taken from the front panels and from areas
of the gowns that were like the front panels. Areas
selected for sampling were free from seams and
other variations (i.e., pockets, tie attachments).
Samples were prepared in accordance with the
r e c o m m e n d e d test methods used.
Surgical gown fabrics. Fabrics A and B were
made of polypropylene fibers in a spun-bond-
melt-blown-spun-bond nonwoven configuration.
Nonwoven fabrics C through E were a blend of
wood pulp and polyester of spun-lace construc-
tion produced by the hydroentanglement process.
Woven fabrics tested were of plain weave
construction. Fabrics in gowns F and G were
produced from multifilament polyester yarns with
little twist. The gown H fabric was made from
cotton/polyester spun yarns. Fabric count, the
n u m b e r of yarns per unit length, is listed in
Table 2.
Testing. Fabric characteristics evaluated in-
cluded thickness, weight, pore size, and oil and
water repellency. Fabric count was determined for
the woven fabrics to establish the n u m b e r of
yarns per inch in both the warp (lengthwise) and
fill (crosswise) fabric direction. Yarn size is
reported in denier, a direct m e a s u r e m e n t system.
As the denier of the yarn increases, the size of the
yarn increases. Fabric samples were conditioned
at least 24 hours in standard atmosphere condi-
tions before the testing according to ASTM D
1776-85 S t a n d a r d Practice for Conditioning
Textiles for Testing.12
Fabric weight (mass) for all fabrics was mea-
 AJIC
18 Leonas and Jinkins February 1997

Table 3. Mean fabric physical characteristics Table 4. Mean fabric repellency characteristics
Mass per unit area* (gm/m2) Thicknesst (l~m) Water repellency rating* Oil repellency rating1-

Fabric Mean SD Mean SD Fabric Mean SD Mean SD

A 61.5 8,1 325 61.1 A 82 8 6.2 0.84

B:I: 87.3 8.8 423 33.5 B::I: 74 6 6.0 1.41
C 74.7 3.7 287 17.7 C 88 5 6.8 0.45
D:I: 144.2 3.1 575 16.0 D$ 82 8 6.6 0.55
E 64.0 1,4 264 13.2 E 70 0 6.0 0
F 89.0 1.2 99 1.8 F 100 0 3.6 0.55
G::I: 169,0 1.5 176 1,1 G::I: 100 0 6.6 0.55
H 99.0 3.2 213 3.3 H 10 22 1.0 0

*Water repellency measured in accordance with AATCC test method

s u r e d in a c c o r d a n c e with ASTM D 3776-85
Standard Method for Mass per Unit Area of a
Woven Fabric. A Mettler balance, Model PM 640
DeltaRange (Mettler Instrument Corp., Hights-
town, NJ) accurate to 0.001 gm, was used. Fabric
thickness was m e a s u r e d in a c c o r d a n c e with
ASTM D 1777-64 Standard Method for Measuring
Thickness of Textile Materials. Thickness was
measured by use of a dial micrometer accurate to
0.0001 inch. Pore size was determined with a
Coulter P o r o m e t e r II (Coulter Scientific In-
struments, Hialeah, Fla.) in a c c o r d a n c e with the
liquid d i s p l a c e m e n t p r o c e d u r e outlined by
Batchu. 13 The fabric face was measured for water
and oil repellency in accordance with AATCC 22-
1983 Water Repellency: Spray Test and AATCC
118-1983 Oil Repellency: H y d r o c a r b o n Resistance
Test, respectively. 14
Fabric contamination procedure. The ability
of the fabrics to prevent liquid strike-through and
bacterial penetration was measured in accor-
dance with the Association of the Nonwovens
Industry (INDA) standard test 80.7a-82 Resistance
to Penetration of Bacteria in Saline Solution. I5
This test measures the resistance of nonwoven
fabrics to the penetration of microorganism sus-
pensions under a hydrostatic pressure. It is appro-
priate for determination of bacterial barrier prop-
erties of nonwoven fabrics used for surgical appli-
cations, is Jubilee jars with stoppers, purchased
from Scientific Machine, Middlesex, N.J., were
used instead of the modified m a s o n jars. The
Jubilee jars were precision threaded with Teflon
gaskets and were used to reduced the leakage that
c o m m o n l y occurs with the modified m a s o n jar
described in the test method. The outer edge of
the jar was t r i m m e d to fit in a petri dish (100 m m
× 15 mm), and the inner diameter was trimmed
22-1980 water repellency: spray test. A higher rating on a scale of 0-100
indicates higher repellency.
1-Oil repellency measured in accordance with AATCC test method 118-
1983 ©il Repellency: Hydrocarbon Resistance Test. A higher rating on a
scale of 0-8 indicates higher repellency.
:l:Double layers.
so a tight seal could be achieved when the fabric
sample was in place.
Escherichia coli and Staphylococcus aureus
were the microorganisms used in this study, and
the growth m e d i u m was Difco tryprone glucose
extract agar (Difco Laboratoriesl Inc., Detroit,
Mich.). The jars, lids, and other equipment were
steam sterilized with a Castle Autoclave, model
M/C 3522 (Castle Autoclave, Rochester, NY) at
121 ° C and 15 psi pressure for 30 minutes expo-
sure. The fabrics were sterilized with ethylene
oxide because the fabrics containing polypropy-
lene fibers (fabrics A and B) are susceptible to
melting and possible distortion when exposed to
the high temperatures used in autoclaving.
The saline solution was prepared by adding 9
(_+ 0.001) gm NaC1 to 1 L deionized water. Bacteria
were introduced into the saline solution by wash-
ing agar slants of the microorganism. Serial plate
counts were completed every 48 hours until the
14-day waiting period r e c o m m e n d e d in the INDA
test method. Bacterial suspensions of 1 × 106
colony-forming units CFU/ml were obtained. This
procedure was followed for each challenge bacte-
ria species used.
The sterile jars were filled with 480 ml prepared
bacteria- containing saline solution, producing a
4.5-inch hydrostatic head. Visual strike-through
of the inoculated saline solution was recorded
when present. After the predetermined time inter-
vals (30 and 60 minutes), the jars were removed.
Approximately 15 ml agar were poured into the
contaminated petri dish and placed in an incuba-
tor at 37 ° C. CFUs were counted after 48 and 72
hours (_+ 2 hours) exposure. Bacterial counts were
AJIC
Volume 25, Number 1 Leonas and Jinkins 19

Table 5. Pore size distribution (ixm)

MFP size Min. Max. Range

Fabric Mean SD Mean SD Mean SD Min. Max.

A 15.40 0.90 12.04 0.36 23.83 1.73 11.64 27.40

B* 13.45 0.87 10.65 0.68 20.37 2.28 10.07 25.00
C 27.99 4.35 19,25 2.16 46.78 4.29 15,62 55.00
D* 22.69 1.56 14.39 0,93 44.02 1.79 13.43 44.02
E 35,01 2.05 20.06 0.96 44.16 1.34 18.71 47.09
F 44.40 0.20 2,79 0.31 6.11 0.25 2.22 6.53
G (layer 1) 3.64 0.34 2.59 0.17 5.03 0.50 2.30 5.87
G (layer 2) 3.52 0.44 2.57 0.32 4.99 0.59 2.20 6.55
H 38,69 1.02 35.54 1,15 43.19 1.17 33.82 45.46

Pore size measured using Coulter Porometer II (Coulter Scientific Instruments, Hialeah, Fla.); Mean of 10 replications.
*Double layers.
MFP, Mean flow pore.

T a b l e 6. Bacterial transmission--by fabric and by bacterial species after 48-hour and 72-hour incubation
S. aureus E. coil

Fabric 30 min* 60 min* 30 min* 60 min*

A NCFU NCFU NCFU NCFU

B1- NCFU NCFU NCFU NCFU
C NCFU NCFU NCFU NCFU
Dt NCFU NCFU NCFU NCFU
E NCFU CFU CFU CFU
F CFU n/aS NCFU n/a:l:
G1- NCFU CFU CFU CFU
H CFU CFU CFU CFU

NCFU, No CFUs present; CFU, CFUs present in one or more replications; n/a, data not available.
*Exposure time.
?Double layers,
SData not available; test was stopped to prevent overflowing of petri dish.

used as a measure to determine the effectiveness
of the fabric as a barrier to bacterial transmission.
Controls were completed to ensure that bacteria
were present in the solution and that no bacteria
other than from the challenge contaminated the
dishes.
RESULTS AND DISCUSSION
The fabric characteristics that were measured
in this study are presented in Tables 2 to 5. The
results of the resistance to bacterial and liquid
transmission are presented in Tables 6 and 7.
Fabric c h a r a c t e r i z a t i o n
The woven fabrics were
Fabric c o n s t r u c t i o n .
all plain weaves. The yarns used in fabrics F and
G were multifilament and did not appear to have
been textured (Figs. 1 and 2). Fiber cross-sections
appeared to be circular for these two fabrics, and
the fabrics had unbalanced weaves. Fabric F had
approximately 9.5% more yarns in the fill than the
warp direction (Table 2). Fabric G had approxi-
mately 10% more yarns in the warp direction than
in the fill (Table 2). Fabric H was quite different in
nature from the other two woven fabrics (Fig. 3).
Although it also was a plain weave fabric, it was
an unbalanced weave with approximately 81%
more yarns in the warp direction. This fabric con-
tained blended yarns of cotton and polyester
fibers; the other two woven fabrics were produced
from 100% polyester fibers. Staple yarns were
used to produce fabric H, resulting in more pro-
truding fiber ends on the fabric surface. This also
contributed to the irregularity of the yarn's sur-
face, which prevented close packing of the yarns
in the fabric.
The five gowns produced from nonwoven fab-
rics represented three different companies (two
from Kimberly-Clark [Roswell, Ga.], two from
Baxter [McGaw Park, Ill.I, and one from B o u n d a r y
Health Care Products [Columbus, Miss.]). With
package information and qualitative and quantita-

20 Leonas and Jinkins
Fig. 1. SEM of fabric F.
tive data, it appeared that the only differences in
the gowns from the same companies were in the
garment design with fabric reinforcements at the
front panel and the sleeves. However, there were
differences between the gowns from the various
companies. The fabric used in gowns C to E all had
similar construction but were different from
gowns A and B. The fabrics used in both of the
gowns from Kimberly-Clark were composite in na-
ture with a randomly laid spun-bond web on the
top and b o t t o m with an additional melt-blown
layer between (Figs. 4 and 5). The polypropylene
filaments in the top and b o t t o m layers were ran-
domly oriented and uniform in size and had
smooth surfaces. Nonwoven fabrics C through E
had similar appearance using scanning electron
microscopy (SEM) techniques of evaluation (Figs.
6 to 8). They contained two distinct fiber types,
w o o d pulp and polyester. The polyester fibers were
circular filaments, and the w o o d pulp fibers were
flat and ribbon-like. The face of the C and D fabrics
contained predominately, and in some cases exclu-
sivel,y, the w o o d pulp fiber. However, the b o t t o m
view showed similar amounts of the polyester and
w o o d pulp. The fibers in the web were in a random
orientation and were held together by mechanical
entanglement.
Fabric w e i g h t . Fabric weight is reported in
Table 3. Average weight for the nonreinforced
gowns ranged from 61.5 gm/m 2 to 99.0 gm/mL For
the three reinforced gowns, fabric B was the light-
est weight at 87.3 gm/m ~, followed by fabric D at
144 gm/m 2 and fabric G at 169 gm/m 2. The three
woven fabrics (F through H) had the most uni-
form weight.
Fabric t h i c k n e s s . Fabric thickness means are
reported in Table 3. Average thickness for the non-
AJIC
February 1997
Fig. 2. SEM of fabric G.
Table 7. Mean fabric physical characteristics
Fabric Liquid strike-through
A ST (1/6)
B* ST (2/6)
C NST
D* NST
E ST (3/6)
F ST (3/6)
G* ST (3/6)
H ST (6/6)
ST, Strike-through in one or more replications; NST,no strike-through,
*Double layers.
Number in parentheses represent number of replications where strike-
through occurred,
reinforced fabrics ranged from a low of 99 m m for
fabric F to 287 m m for fabric C. The woven fab-
rics had the most uniform thickness. Fabric A was
least uniform and was produced from a compos-
ite fabric that was thermally bonded. The great
variation in the thickness of fabric A could be a
result of the nonuniform surface created through
the thermal bonding process. This type of bonding
has depressed areas where the heat and pressure
of the bonding mechanism have come in contact
with the fabric. This is visually noticeable. SEM
micrographs (Figs. 3 and 4) also depicted areas of
the fabric with varying quantities of the top and
b o t t o m layer filaments, which also contributes to
the nonuniform thickness. Thickness of the three
reinforced fabrics ranged for a low of 176 m m for
fabric G to 575 m m for fabric D. Fabric D was the
thickest fabric in this study.
Fabric r e p e l l e n c y . The repellency characteris-
tics for each fabric are reported in Table 4. Water
repellency ratings for each of these fabrics ranged
AJIC
Volume 25, Number 1
Fig. 3. SEM of fabric H.
Fig. 4. SEM of fabric A.
from 10 to 100. The two multifilament woven fab-
rics (F and G) were rated 100 (maximum repel-
lency) in each replication. The m e a n repellency
rating for the third woven fabric (fabric H) was
rated a 10. Fabric H had the lowest repellency rat-
ing and highest standard deviation of the eight
fabrics evaluated. W h e n evaluating the SEM
micrographs, it is apparent that fabric H had the
least uniform surface with m a n y fiber ends pro-
truding. In addition, this fabric had the highest
m i n i m u m pore size (Table 5). These factors may
result from a nonuniform or lack of treatment
with a repellent finish. The mean repellency rat-
ings of the nonwoven fabrics ranged from a low of
70 for fabric E to a high of 88 for fabric C.
For fabric oil repellency, a zero rating reflects
no resistance to wetting for a liquid of the highest
surface tension (Squibb Mineral Oil [Bristol-
Myers Squibb Pharmaceutical, Princeton, NJ], 35
dynes/cm at r o o m temperature). The m a x i m u m
Leonas and Jinkins 21
Fig. 5. SEM of fabric B.
Fig. 6. SEM of fabric C.
rating is 8, reflecting resistance to wetting by a liq-
uid of low surface tension, n-heptane (18.14
dynes/cm 2 at r o o m temperature). 13 Fabric H
received a mean oil repellency rating of 1, consid-
erably lower than the other fabrics in this study.
This result indicated that this fabric probably had
no liquid-repellent finish. Fabric F had the next
lowest mean rating (3.6). The remaining six fab-
rics were relatively close to one another, with
mean repellency ratings of 6.0 to 6.8. Fabrics B
and E each had a mean rating of 6.0, fabric A had
a rating of 6.2, fabrics D and G had ratings of 6.6,
and fabric C had the highest mean rating (6.8).
Resistance to liquid strike.through and
bacteria transmission
In this study transmission of bacteria was deter-
mined by the presence of CFUs on the agar 48 and
72 hours after contamination to the bacteria con-
taining saline solution, as described in INDA

2 2 Leonas and Jinkins
Fig. 7. SEM of fabric D.
Standard Test 80.7a-82. Liquid strike-through was
determined visually by the presence of moisture
in the petri dish by use of guidelines established in
INDA Standard Test 80.70, Saline Repellency of
Nonwovens. With this criteria, four of the eight
fabrics (A to D) prevented transmission of bacte-
ria for both bacterial species (Table 6), but only
two (fabrics C and D) prevented liquid strike-
through for all replications (Table 7). In this study,
liquid strike-through was not always accompa-
nied by bacterial transmission. In addition, there
were no instances where bacteria transmission
o c c u r r e d u n a c c o m p a n i e d by liquid strike-
through.
Four of the fabrics in this study (A to D) pre-
vented transmission of S. aureus. These were four
of the five nonwoven fabrics evaluated in this
study. The other nonwoven fabric (E) allowed the
bacteria to transmit in only one replication and
only one CFU was counted. This CFU was seen at
the 60-minute testing interval, indicating that fab-
ric E loses its barrier effectiveness over time. For
fabric E liquid strike-through occurred only in the
replication that allowed bacterial transmission.
This result indicates that this fabric allows the
bacteria to transmit with the liquid. Fabric F
allowed liquid strike-through and bacterial trans-
mission in two of the three replications. Fabric G
allowed liquid strike-through in two of the three
replications. One strike-through incident
occurred early in the first 30-minute contamina-
tion period and the other occurred after 30 min-
utes of contamination. CFUs were present only in
the replication where strike-through occurred
early in the first 30 minutes. Fabric H provided no
resistance to liquid strike-through. On the inver-
sion of the jar there was i m m e d i a t e strike-
AJIC
February 1997
Fig. 8. SEM of fabric E.
through, and the jar had to be removed from the
petri dish to prevent overflowing of the petri dish.
CFUs greater than 300 were present for all repli-
cations of Fabric H.
Five of the fabrics in this study (A to D, and F)
prevented t r a n s m i s s i o n of E. coli. Fabric E
allowed liquid strike-through and bacterial trans-
mission in one of two replications (one replication
was discarded because of leakage at the jar lid
seal). CFUs greater than 300 were present at 48-
and 72-hour evaluations. As for S. aureus, fabric
H provided no resistance to the liquid strike-
through, and the jar was removed to prevent over-
flowing of the petri dish. CFUs were present in all
replications.
When testing three of the nonwoven fabrics (A,
B, and C) against E. coli, a condensation pattern
appeared on the petri dish. In accordance with the
test method, this condensation is not classified as
liquid strike-through. However, bacteria was not
transmitted in any of these replications, indicat-
ing that the construction of the fabric prevented
bacterial m o v e m e n t through the test sample.
Fabric F allowed six pinhead-sized drops of liquid
to transmit in one replication, but no bacteria was
present. The other two replications for this fabric
allowed no strike-through.
Fabric H allowed liquid strike-through and bac-
teria transmission to occur in all replications, for
both bacterial species. This fabric had the lowest
oil and water repellency ratings and also had the
largest m i n i m u m pore size (33.82 mm). These
characteristics contributed to the fabric's inability
to prevent liquid strike-through and bacterial pen-
etration. The low repellency rating indicates that
this fabric wets out very easily. If the bacteria is
carried by liquids, it will rapidly be moved
AJIC
Volume 25, Number 1
through the fabric. The large pore size indicates
that the bacteria and liquid can easily move
through the fabric structure, resulting in immedi-
ate transmission.
Fabric E also allowed the transmission of both
bacterial species. The water repellency rating of
this fabric was the second-lowest, indicating that
the fabric will wet out easily. Its oil repellency rat-
ing was third lowest, equal with that of fabric B.
Fabric B did not permit bacterial transmission,
although its oil repellency was equal to that of
fabric E. This finding implies that fabric con-
struction plays an important role in the preven-
tion of bacterial transmission. Pore size of fabric
E ranged from 18.71 to 46.09 mm; fabric B's pore
size ranged from 11.86 m m to 24.33 mm.
Fabrics F and G allowed liquid strike-through
of both bacterial saline solutions and transmis-
sion of E. coli and S. aureus, respectively. These
fabrics were similar in construction; both were
produced from multifilament yarns that were
tightly packed in a plain weave. They had the
same water repellency rating (100) and almost
identical pore size measurements (2.20 to 6.55
m m vs 2.22 to 6.53 mm), which were considerably
lower than the other fabrics tested in this study.
The smooth fabric surface promotes liquid move-
ment along the surface versus penetration, but the
tight packing of the yarns and the smooth fila-
ment fibers also enhance wicking of the liquid.
The wicking effect m a y have resulted in liquid
strike-through and bacterial transmission.
However, bacteria was not always transmitted
when liquid was transmitted. This indicates that
the fabric construction is inhibiting bacterial
movement through the fabric.
The remaining four nonwoven fabrics (A to D)
did not allow transmission of either bacterial
species. However, fabrics A and B did permit liq-
uid transmission. In some cases there was only
condensation in the petri dish when the jar was
removed, which is not classified as liquid strike-
through. This is actually a positive characteristic,
and it indicates that the fabric is allowing the flow
of air and moisture vapor, which contributes to
the comfort characteristics of the fabric as a sur-
gical gown.
A combination of several fabric characteristics
controlled the barrier properties of the surgical
gown fabrics studied. Fabric construction, repel-
lency, and pore size contributed to gown perfor-
Leonas and Yinkins 2 3
mance. Four of the five nonwoven fabrics in this
study proved to be an effective barrier against the
transmission of S. aureus and E. coli in a saline
solution. Each of the three woven fabrics evaluat-
ed allowed some transmission of these bacterial
species. Liquid strike-through was not always
accompanied by bacterial transmission. Higher
repellency ratings and smaller pore size generally
corresponded with higher barrier properties. In
this study, the reinforced fabrics did not perform
better or worse than the single-layer fabric gowns.
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