Reusable medical gowns: comfort, protection and less healthcare waste

Reusable medical gowns: comfort, protection and less healthcare waste

A medical gown is an essential part of personal protective equipment across hospitals and other healthcare environments. During the COVID-19 pandemic, demand for disposable PPE increased dramatically, placing additional pressure on supply chains and contributing to growing volumes of healthcare waste.

As hospitals consider more resilient and sustainable product models, reusable gowns are receiving increased attention.

Research conducted at Western Health in Melbourne examined staff experiences following the introduction of a reusable isolation gown as the default PPE gown across its intensive care units. The findings provide practical insight into staff comfort, usability, perceived protection and the potential environmental and economic benefits of reusable products.

They also highlight the importance of supporting any reusable gown program with appropriate product selection, staff education, controlled laundering, infection-prevention processes and reliable supply.

What is a medical gown?

The term medical gown can describe several garments used to help protect healthcare workers and patients during clinical activities.

Different gown types are designed for different applications, protection levels and clinical environments. They may include:

• Isolation gowns
• Procedure gowns
• PPE gowns
• Surgical gowns
• Reusable theatre gowns
• Patient gowns

The appropriate product depends on the intended task, anticipated exposure, required barrier performance and the healthcare organisation’s infection-prevention and clinical-governance requirements.

A PPE gown used for isolation or general clinical care should not automatically be treated as interchangeable with a surgical gown used in an operating theatre. Each product must be assessed against its intended use and applicable performance requirements.

What did the Western Health study examine?

The research was published in Australian Health Review in 2022 and examined staff views following the introduction of reusable isolation gowns across Western Health’s intensive care units.

Reusable gowns became the default ICU PPE gown on 4 April 2022 after approval from Western Health’s infectious diseases, infection-prevention and ethics teams.

The reusable isolation gown examined in the project:

• Conformed to the Association for the Advancement of Medical Instrumentation Level 3 standard
• Was manufactured from 100% polyester
• Had a stated lifecycle of 75 washes

Approximately 165 ICU nursing staff were invited to participate in a voluntary survey. A total of 44 staff responded, although not every participant answered every question.

The survey assessed:

• Comfort
• Breathability
• Durability
• Appearance
• Ease of putting on the gown
• Ease of removing the gown
• Perceived protection compared with disposable gowns
• Overall usability compared with disposable alternatives

Staff rated the reusable medical gown highly for comfort

Comfort is an important consideration for any medical gown, particularly when healthcare workers may need to wear PPE for extended periods.

Of the 44 staff members who rated comfort:

• 23 described the reusable gown as comfortable
• 13 described it as very comfortable
• Five were neutral
• Three rated it as uncomfortable or very uncomfortable

This meant 36 of 44 respondents considered the reusable gown comfortable or very comfortable.

The researchers noted that these findings differed from concerns previously reported in the literature about the comfort of reusable gowns.

Breathability received a more varied response. Of the 44 respondents:

• 22 rated breathability as good or very good
• 15 were neutral
• Seven rated it as poor or very poor

This suggests that staff acceptance cannot be assessed through barrier performance alone. Comfort, breathability and the conditions in which the gown will be worn also influence the user experience.

Staff perceived strong protection and durability

Most participating staff viewed the reusable PPE gown positively when considering protection and durability.

Of the 43 respondents who compared its effectiveness and protection with disposable gowns:

• 32 considered the reusable gown better or far better
• Nine considered it about the same
• Two considered it worse
• No respondents rated it far worse

These results reflect staff perceptions rather than independently measured clinical outcomes. The study did not test infection transmission or compare patient outcomes between reusable and disposable gowns.

Durability was also rated highly. Of the 44 respondents:

• 42 rated the reusable medical gown’s durability as good or very good
• Two were neutral
• No respondents rated its durability as poor or very poor

Product durability is particularly important within a reusable program because gown performance must be maintained through repeated use, controlled laundering, inspection and eventual replacement.

Donning and doffing require careful consideration

Survey participants generally found the reusable gown easy to put on. However, removing the gown produced more mixed feedback.

Some staff reported difficulty untying the gown during doffing. The researchers suggested this was likely because the reusable ties needed to be untied rather than torn away, as may occur with some disposable gowns.

Overall, staff considered the combined donning and doffing experience broadly equivalent to disposable gowns.

This feedback demonstrates why product implementation should include:

• Clear donning and doffing instructions
• Staff education and demonstrations
• Infection-prevention review
• Opportunities for staff feedback
• Monitoring during the transition period
• Product or design adjustments where appropriate

A reusable medical gown may perform well, but successful adoption also depends on how easily it fits into established clinical workflows.

Potential reductions in emissions and solid waste

The researchers estimated the environmental impact of the reusable gown by applying lifecycle inventory data from previous research and adjusting it for the weight of the gown used in the Western Health project.

Although the product had a stated lifecycle of 75 washes, the calculation assumed 60 uses to account for potential gown losses.

Compared with the disposable alternative, the researchers estimated:

• A 41% reduction in global warming potential
• A 95% reduction in solid-waste generation

These figures were modelled estimates rather than results from a complete, project-specific lifecycle assessment.

The environmental performance of a reusable PPE gown can vary according to:

• The number of times it remains in service
• Product loss and damage
• Laundry water and energy efficiency
• Transport requirements
• Wash and drying processes
• Packaging
• End-of-life management

Nevertheless, the study indicates that a well-managed reusable gown program may provide a meaningful opportunity to reduce reliance on single-use products and decrease healthcare waste.

Potential cost savings across the gown lifecycle

The study also estimated economic savings of more than A$1 each time the reusable gown was worn compared with the disposable alternative.

Actual cost outcomes will vary between healthcare organisations and depend on factors including:

• Product purchase or rental arrangements
• Number of gown uses
• Loss and replacement rates
• Laundering and processing costs
• Collection and delivery requirements
• Internal handling and distribution
• Disposable-product prices
• Waste-management costs
• Required stock and contingency levels

A reusable product should therefore be assessed across its complete lifecycle rather than only comparing the upfront price of one reusable gown with one disposable gown.

Medical gown, PPE gown and surgical gown: understanding the difference

Medical gown and PPE gown are broad terms that can describe protective garments used across different healthcare applications.

An isolation gown may be used during patient care where protection from anticipated exposure is required. A surgical gown is designed for use during surgical or other sterile procedures and must meet the performance and sterility requirements applicable to its intended use.

Reusable surgical gown programs can require additional controlled activities, including:

• Product inspection
• Folding and pack assembly
• Controlled wrapping
• Validated sterilisation
• Batch recording
• Integrity checks
• Secure storage and delivery

Healthcare organisations should select each gown according to its intended application rather than assuming all protective gowns offer the same level or type of protection.

Hygiene and infection prevention across the gown lifecycle

The safe reuse of healthcare garments depends on controlled processing and careful handling throughout the product lifecycle.

Ensign processes healthcare linen and eligible garments through controlled workflows designed to support effective disinfection and reduce the risk of cross-contamination.

These processes can include:

• Separation of soiled and clean processing areas
• Validated wash programs
• Controlled handling through laundering and finishing
• Product inspection
• Appropriate storage
• Protected transport
• Scheduled collection and delivery
• Documented operational controls
• Quality monitoring and staff training

For reusable medical gowns, processing must be aligned with the product’s construction, intended use, manufacturer requirements and the healthcare organisation’s infection-prevention framework.

Explore Ensign’s managed healthcare linen services.

Sterile capabilities for reusable surgical gowns

Ensign also supports eligible reusable theatre products through dedicated sterile-processing capabilities.

Within dedicated Blue Rooms, reusable healthcare linen is inspected, folded, assembled into packs and wrapped under controlled conditions. Each pack is then sterilised through a validated cycle, batch-recorded, checked and securely sealed to protect its integrity through storage, delivery and until the point of use.

These capabilities can support selected reusable surgical gowns, drapes, wraps and procedure packs where sterile processing is required.

Sterilisation services are currently available in Victoria and New Zealand only and remain subject to product, location and service capability.

Ensign’s broader healthcare and theatre product range includes reusable surgical gowns, drapes, wraps, patient apparel and other products designed around healthcare requirements.

Building a managed reusable gown program

Moving from disposable to reusable medical gowns involves more than changing the product placed at the point of use.

A managed program must coordinate:

• Gown selection and performance requirements
• Staff sizing and product allocation
• Agreed clinical applications
• Infection-prevention requirements
• Collection and segregation
• Controlled laundering
• Product inspection
• Sterile processing where required and available
• Repairs and replacement
• Stock monitoring
• Internal distribution
• Contingency inventory
• Usage and service reporting

Ensign can incorporate reusable healthcare garments into a coordinated linen supply and management program.

By managing supply, collection, processing, inspection, stock and scheduled delivery together, healthcare organisations can explore reusable alternatives while maintaining focus on clinical requirements and product availability.

Planning a transition to reusable gowns

Before introducing a reusable PPE gown or surgical gown, healthcare organisations should consider:

• Intended clinical use
• Required protection level
• Applicable product standards
• Staff comfort and breathability
• Donning and doffing requirements
• Product durability
• Laundering and disinfection requirements
• Sterilisation requirements, where applicable
• Staff education
• Expected usage volumes
• Stock and contingency requirements
• Collection and internal distribution
• Product loss and replacement
• Environmental and cost measurement
• Ongoing staff feedback

A structured product trial can help infection-prevention, clinical, procurement, sustainability and operational teams assess suitability before wider implementation.

Staff feedback should form an important part of this process, particularly where a reusable gown differs from the disposable product it replaces.

Reusable gowns can support broader healthcare goals

The Western Health study provides useful insight into how ICU staff experienced a newly introduced reusable isolation gown.

Among participating staff, the gown received strong ratings for comfort, durability and perceived protection. The researchers also estimated reductions in global warming potential and solid-waste generation, along with potential savings of more than A$1 per use compared with the disposable alternative.

The study was based on a relatively small, voluntary staff survey at one healthcare organisation. It assessed staff perceptions and modelled environmental and economic impacts rather than measuring infection outcomes or completing a project-specific lifecycle assessment.

Even with these limitations, the findings demonstrate that reusable medical gowns can be considered through multiple lenses: protection, comfort, usability, waste, cost and supply resilience.

The most effective transition is not simply a product substitution. It is a managed program supported by suitable products, clinical oversight, staff education, controlled processing, reliable inventory and ongoing performance monitoring.

Explore reusable healthcare gowns

Ensign works with public and private hospitals, day surgeries and other healthcare providers to develop managed healthcare linen and reusable product programs around their clinical, operational and continuity requirements.

Explore Ensign’s healthcare solutions or contact our healthcare team to discuss reusable medical gowns, theatre products and managed healthcare linen services.

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CTA link: https://www.ensignservices.com.au/sectors/healthcare

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Source

Angelopoulos N, Angiolella S, Lyons P, Ross B and McGain F. “Survey of intensive care unit staff views on a newly introduced reusable isolation gown.” Australian Health Review. Published 20 October 2022.

DOI: https://doi.org/10.1071/AH22223

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