impermeability. We don't want exposure to the patient and vice versa in
the OR."
The Buffalo Surgery Center in Amherst, N.Y., goes through about
25,000 gowns a year. The 3 things that matter most to the person with
the purchasing power: good price, an ample cuff to grip gloves and
strong permeability to prevent strikethrough.
"My surgeons would complain if I bought a gown that's not imper-
meable to strikethrough," says administrator Jeannette M. Moretti,
RN, CNOR. "Otherwise, they just use what I give them."
Ms. Moretti recently switched gown vendors to take advantage of
better pricing ($1.44 apiece). She stocks only 2 sizes — "large and
extra large fit everybody" — and prefers a longer cuff that stays snug
on the wrist and secures the gloves in place. "A shorter cuff can pull
up and expose the wrist," she says, calling that gap a perfect opportu-
nity for blood and bodily fluids to contact a surgeon's skin.
Appropriate level of protection
How much barrier protection do your surgeons need? There are 4 lev-
els of barrier performance, with Level 1 being the lowest level of pro-
tection and Level 4 being the highest. The barrier performance classifi-
cation levels are determined by a couple of factors: the gown's resist-
ance to penetration by liquid contact, and the anticipated blood and
bodily fluid exposure from the case. Gowns classified as Level 1 or 2
offer minimal or low barrier protection, while Level 3 or 4 gowns pro-
vide moderate or high barrier protection. A cataract surgeon will need
less protection than, say, a general or orthopedic surgeon.
"The only ones I have ever used are Level 3 and 4," says Dr. Renton.
"Level 3 is a little lighter, and adequate for the majority of the cases I
do. We have Level 4, and the cost difference is negligible, so when I
need them, they are there."
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