Reducing Skin and Clothing Contamination of Healthcare Personnel by Improving Ease of Removal of Isolation Gowns

Abstract

Background. Contamination of the skin and clothing of healthcare personnel during removal of personal protective equipment (PPE) contributes to dissemination of pathogens and places personnel at risk for acquisition of infection. The quality of gown material and ease of removal may play a role in determining if contamination occurs. We tested the hypothesis that contamination of personnel during removal of PPE would be reduced when wearing an impervious coated polypropylene gown with Flexneck technology (double elastic closure that can snap during doffing) versus a standard polyethylene isolation gown. Methods. Healthcare personnel were randomized to perform simulations of contaminated PPE removal with either the polypropylene gown with Flexneck technology or the standard polyethylene gown; on the following day a simulation was conducted with the alternate gown. The gown and gloves were contaminated with 8 log10 plaqueforming units (PFUs) of bacteriophage Phi X‐174 and 0.5 mL of fluorescent lotion. After PPE removal, hands and clothing were assessed for contamination with fluorescent lotion using a black light and cultured for the bacteriophage. Results. During simulations of contaminated PPE removal, the frequency of skin and/or clothing contamination was significantly less when the polypropylene gown with Flexneck technology was used versus the standard PE gown (Phi X‐174; 58% versus 52%, P = 0.45). Contamination of skin and clothes was significantly less with the use of PPE gown with Flexneck technology compared to the standard polyethylene gowns (Phi X‐174; 40% versus 87%, P = .02; fluorescent lotion, 0% versus 33%, P = .04). Mean PFUs of bacteriophage recovered from skin and clothing was also significantly lower when polypropylene gowns were worn (P = 0.03). Personnel noted that the polypropylene gown was easier to remove than the standard gown. Conclusion. Our results suggest that simple modifications of current gowns could improve ease of removal and reduce the incidence of contamination of personnel during PPE removal.