Researching reusable operating theatre clothing

Disposable protective clothing is being adopted more readily by hospitals despite the fact that it flies in the face of German waste laws. Now a new funded project hopes to develop reusable clothing that is more comfortable and environmentally friendly

The joint research project is developing innovative reusable operating theatre textiles

A German research project focused on developing reusable operating theatre textiles that are more comfortable to wear and, at the same time, more durable because they can be cleaned in a gentler process, is being sponsored by the Alliance for Industrial Research. With this project, which will run until the start of 2016, both the wfk – Cleaning Technology Institute e.V. and the Hohenstein Institute are complying with the requirements of the European Commission’s Closed Cycle and Waste Management Act (KrWG).

The KrWG, as implemented in the Waste Framework Directive RL 2008/98/EC, has been part of German law since 2012. The reform states that to avoid waste, materials should remain in the production cycle for as long as possible. However, in the healthcare sector, and especially in hospitals, the trend is in the opposite direction. In the interests of ease of handling, guaranteed sterility at all times and – apparently – cost considerations, the proportion of disposable operating theatre clothing used in hospitals is increasing all the time.

The resulting waste amounts to about 3.2kg of textiles/patient/day that have to be disposed of correctly, equating to an annual 1,200kg mountain of waste for every hospital bed.

Medical textiles such as operating theatre clothing are classed as licensed medical products and subject to various textile technology requirements under the European DIN EN 13795 standard

Medical textiles such as bed covers and operating theatre clothing are classed as licensed medical products and are subject to various textile technology requirements under the European DIN EN 13795 standard. These include, for example, mechanical resistance, microbiological purity and a barrier effect against fluids. These numerous standards, designed to ensure the safety of the wearer, mean that the wearing comfort of operating theatre clothing, and especially of disposable clothing, is a secondary consideration.

To offset the relatively high procurement cost of reusable protective clothing, it must be able to withstand about 50–70 cycles of use and reprocessing. Consequently, the wearing comfort of reusable textiles always suffers – yet comfort is precisely the characteristic for which, in addition to environmental performance, they are superior to disposable textiles.

In the light of this problem, this joint research project is developing innovative reusable operating theatre textiles that offer not only greater comfort but also an extended service life. In the project, the Hohenstein Institute is optimising the materials used for reusable protective textiles to ensure the best possible thermophysiological characteristics.

An imbalance between the production and the transport of body heat makes the operating theatre team feel less comfortable and can also impair their alertness and performance

The research team, led by Dr Bianca-Michaela Wölfling, is currently studying the operating theatre clothing that is available on the market with regard to its textile technology and clothing physiology properties. They are looking in particular at the interaction between body, climate and clothing, since an imbalance between the production and the transport of body heat not only makes the surgeon and operating theatre team feel less comfortable as they work, but can also impair their alertness and performance.

Studies are being carried out using both the Hohenstein Skin Model and volunteers in a climate-controlled chamber, in a range of realistic conditions. Proposals for how operating theatre textiles could be further developed will be produced on the basis of the research results. At the same time, the wfk is researching cleaning processes that would minimise the thermal and mechanical wear on the protective textiles to extend their working life. To make sure that their work is also resource-efficient, the researchers are focusing on pre-activated disinfectant systems and enzymes that are active at low temperatures.

Research is going on into cleaning processes that would minimise the thermal and mechanical wear on protective textiles

The reduction in the washing temperature and the mechanical stresses, together with specially developed cleaning and disinfecting routines, have resulted in an innovative cleaning process. First, it enables the protective and thermo-physiological textile functions to be preserved better than under the current method. Second, it results in an improvement of about 25% in the lifespan of reusable operating theatre textiles.

The innovative reusable protective textiles offer both improved wearing comfort and a longer service life thanks to resource-efficient cleaning processes. However, in addition to the ecological benefits, the economic benefits of the research project should not be overlooked. Hospitals could potentially save about €12.9m as a result of the extended usability of protective textiles.

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