Laundering and Restoration of Reusable Surgical Barrier Textiles Steven J. Tinker Director, Research...

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Laundering and Laundering and Restoration of Reusable Restoration of Reusable Surgical Barrier TextilesSurgical Barrier Textiles

Steven J. TinkerSteven J. TinkerDirector, Research & DevelopmentDirector, Research & Development

Gurtler Industries, Inc.Gurtler Industries, Inc.

Reusable Surgical TextilesReusable Surgical Textiles

Barrier Surgical Gowns and Drapes - Barrier Surgical Gowns and Drapes - Fluid Resistant TextilesFluid Resistant Textiles Protect health care workers from Protect health care workers from

blood and bodily fluidsblood and bodily fluids Provide comfort and allow for Provide comfort and allow for

sterilizationsterilization Several degrees of protection Several degrees of protection

availableavailable

Fabric TechnologyFabric Technology MuslinMuslin

Traditional reusable OR fabricTraditional reusable OR fabric Poly/Cotton BlendPoly/Cotton Blend

Repellent finishesRepellent finishes Polyester Microfiber TechnologyPolyester Microfiber Technology

Continuous filament threadsContinuous filament threads Tightly wovenTightly woven Repellent finishesRepellent finishes

MuslinMuslin

Cotton/polyester blendsCotton/polyester blends

100% polyester ‘microfiber’100% polyester ‘microfiber’

Laminated fabrics – Gore-TexLaminated fabrics – Gore-Tex®®

Reusable Surgical Textiles Reusable Surgical Textiles

Microfiber TechnologyMicrofiber Technology

Continuous filaments vs. staple fibersContinuous filaments vs. staple fibers Significantly lower linting potentialSignificantly lower linting potential

Fluid Repellent FinishesFluid Repellent Finishes

Polyester is “naturally” hydrophobicPolyester is “naturally” hydrophobic But highly oleophilicBut highly oleophilic

FluoropolymersFluoropolymers Water and oil repellentWater and oil repellent Mill applied, curedMill applied, cured

Environmental IssuesEnvironmental Issues

Reusable Surgical Textiles can reduce Reusable Surgical Textiles can reduce medical waste significantlymedical waste significantly One garment can replace 150-200 One garment can replace 150-200

disposable gownsdisposable gowns Considerable medical waste Considerable medical waste

incineration or landfill impactincineration or landfill impact Significant cost savings can be Significant cost savings can be

achievedachieved

Environmental IssuesEnvironmental Issues

AHA & EPA agreement: Hospitals for a AHA & EPA agreement: Hospitals for a Healthy EnvironmentHealthy Environment Goals: Reduce the overall volume of Goals: Reduce the overall volume of

hospital waste (both regulated and hospital waste (both regulated and non-regulated waste) bynon-regulated waste) by 33 percent by 2005 and 33 percent by 2005 and 50 percent by 2010 50 percent by 2010

See www.h2e.orgSee www.h2e.org

Regulatory IssuesRegulatory Issues

Surgical gowns, drapes wraps and Surgical gowns, drapes wraps and towels are “Class II Medical Devices” as towels are “Class II Medical Devices” as defined by FDAdefined by FDA

Commercial laundries that reprocess Commercial laundries that reprocess surgical textiles may need to register surgical textiles may need to register with FDAwith FDA

Reporting Requirements –Reporting Requirements – Strike-throughStrike-through Complaint handlingComplaint handling

Standard Laundry ProcessStandard Laundry Process TimeTime

30-45 minutes30-45 minutes TemperatureTemperature

160-180°F160-180°F Mechanical ActionMechanical Action

Rated Capacity of WasherRated Capacity of Washer Chemical ActionChemical Action

pH 11.0-11.5pH 11.0-11.5 Surface Active AgentsSurface Active Agents

Standard Laundry Process

Temperature Time

Chemical Action

Mechanical Action

Reusable Care ConcernsReusable Care Concerns

Low absorptivityLow absorptivity Laminated fabrics: Impervious to fluid Laminated fabrics: Impervious to fluid

transmissiontransmission Barriers reduce chemical Barriers reduce chemical

transmission through fabrictransmission through fabric Reduced soil removal efficacyReduced soil removal efficacy

Polyester - affinity to oily soilsPolyester - affinity to oily soils Recommended temperature between Recommended temperature between

140-160140-160°F°F Use nonionic detergents – more Use nonionic detergents – more

difficult to rinsedifficult to rinse

Rinsing of detergent is key to barrier Rinsing of detergent is key to barrier performanceperformance Any residual detergent will affect Any residual detergent will affect

barrier performance negativelybarrier performance negatively Must add extra rinsing time and stepsMust add extra rinsing time and steps No fabric softeners or anti-static No fabric softeners or anti-static

agents can be usedagents can be used

Polyester - Alkaline hydrolysis potentialPolyester - Alkaline hydrolysis potential Reduce the amount of alkali, Reduce the amount of alkali,

reduce pH to <10.5reduce pH to <10.5 Keep temperature <180Keep temperature <180°F°F

Soil CharacteristicsSoil Characteristics

Blood SoilsBlood Soils Low temperature flushes to reduce “setting”Low temperature flushes to reduce “setting” Enzyme detergent in prewash zone of tunnelsEnzyme detergent in prewash zone of tunnels

Oily Soils – Body Oils or Mineral OilsOily Soils – Body Oils or Mineral Oils Polyester has a high affinity for these soilsPolyester has a high affinity for these soils High surfactant detergents with oily soil High surfactant detergents with oily soil

emulsification propertiesemulsification properties Cloud point of detergent 100-120Cloud point of detergent 100-120°F°F High phosphate detergents work betterHigh phosphate detergents work better Solvent-based detergent additives can helpSolvent-based detergent additives can help

Tape ResidueTape Residue Use special tape with water/alkali soluble Use special tape with water/alkali soluble

adhesiveadhesive Very difficult – if the wrong tape is usedVery difficult – if the wrong tape is used Solvent detergent re-washes, high Solvent detergent re-washes, high

temperature reclaim processtemperature reclaim process

Fluoropolymer finishes: Can be Fluoropolymer finishes: Can be removed with harsh laundering removed with harsh laundering processesprocesses Reduce alkaliReduce alkali Avoid use of oxalic acidAvoid use of oxalic acid Avoid some harsh solventsAvoid some harsh solvents

Barrier Fabric ProcessBarrier Fabric Process Increased TimeIncreased Time

45-60 minutes45-60 minutes Reduced TemperatureReduced Temperature

140-160140-160°F°F Increase Mechanical ActionIncrease Mechanical Action

65-75% of rated capacity65-75% of rated capacity Change Chemical RatiosChange Chemical Ratios

More detergent, less alkaliMore detergent, less alkali

Barrier Fabric Process

Mechanical ActionChemical

Action

Temperature

Drying ProcessDrying Process

Achieve “bone-dry” stateAchieve “bone-dry” state Dry at 170-200Dry at 170-200°F°F Maintain maximum temperature for Maintain maximum temperature for

3-5 minutes3-5 minutes Cool-down to 100°FCool-down to 100°F

Reusable ProtectionReusable Protection

Suter test - Hydrostatic resistanceSuter test - Hydrostatic resistance AATCC 127-1985AATCC 127-1985

Oil and water repellency testsOil and water repellency tests AATCC 118-1992AATCC 118-1992

Resistance of Protective Clothing Materials to Resistance of Protective Clothing Materials to penetration by blood or bloodborne pathogenspenetration by blood or bloodborne pathogens ASTM F1670-95ASTM F1670-95 ASTM F2671-95ASTM F2671-95

Repellency PerformanceRepellency Performance

Oil Repellency is a major issue in Oil Repellency is a major issue in surgical protective barrier materialssurgical protective barrier materials Suter test doesn’t reflect oil Suter test doesn’t reflect oil

repellency performancerepellency performance Oil stains can cause concern with Oil stains can cause concern with

health care personnelhealth care personnel

Repellency Performance

0 25 50 75 100 125 150

Number of Cycles

Barrier RejuvenationBarrier Rejuvenation

Modified fluoropolymers can be added Modified fluoropolymers can be added in the final rinse cyclein the final rinse cycle Use rate of 2-6 oz/cwtUse rate of 2-6 oz/cwt Cost of 2-4 cents per garmentCost of 2-4 cents per garment Good drying is critical Good drying is critical

““Maintenance” application of polymer Maintenance” application of polymer can extend life beyond 150-200 uses can extend life beyond 150-200 uses

ReferenceReference

ANSI/AAMI ST65:2000 – ANSI/AAMI ST65:2000 –

Processing of reusable surgical textiles Processing of reusable surgical textiles for use in health care facilitiesfor use in health care facilities

ANSI/AAMI PB70:2003 –ANSI/AAMI PB70:2003 –

Liquid barrier performance and Liquid barrier performance and classification of protective apparel and classification of protective apparel and drapes in health care facilities.drapes in health care facilities.

Additional SourcesAdditional Sources

ARTA - American ARTA - American Reusable Textile Reusable Textile AssociationAssociation www.arta1.comwww.arta1.com

TRSA – Textile TRSA – Textile Rental Services Rental Services AssociationAssociation www.trsa.orgwww.trsa.org

Laundering and Laundering and Restoration of Reusable Restoration of Reusable Surgical Barrier TextilesSurgical Barrier Textiles

Steven J. TinkerSteven J. Tinkersjtinker@gurtler.comsjtinker@gurtler.com

Laundering and Restoration of Reusable Surgical Barrier Textiles Steven J. Tinker Director, Research...

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