MSL Steriwear<sup>®</sup> MSL Steriwear®
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Recommended Steriwear® gowning sequence & correct procedures

 

Garments should be worn correctly to serve the intended purpose. The gowning procedure described here is intended to serve as a guide; you should draw up your own gowning sequence by modifying this procedure wherever necessary.

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Good gowning practice

  • Remove street footwear. Change into cleanroom footwear.
  • Remove all street garments not necessary for warmth or modesty.
  • Remove and safely store watches, rings, cigarettes, lighters, jewellery, purse and other personal effects.
  • Scrub down. Remove cosmetics, if any applied. Use appropriate cleanroom grade detergent compatible with the disinfectants used to remove physical contaminants.
  • Washing of hands and forearms deserves special care. The under surfaces of fingernails should be thoroughly cleaned with a soft nylon brush, or when necessary, with a scraper.
  • Wear gowning cap. This is optional at this point in the gowning sequence. The purpose is to conceal the hair at an early stage, and keep it covered thereafter.
  • Enter change room. Installation of a good quality “tacky” mat at entrance is recommended. If you are not sure of the quality, you are better off without it. Even with a good tacky mat, research has established that you need to walk a distance of 20 steps before you have left behind 95% of your footborne debris. Having a standard “Welcome” size tacky mat may not be as useful as imagined.
  • Wear gowning gloves. This is also optional at this stage. The objective is to avoid contact with washed bare hands. Select gloves of proper style and size.
  • Carefully put on the first glove, touching the outside of the glove as little as possible. Then put on the second glove, taking care not to touch anything other than cleanroom apparel.
  • Obtain cleanroom apparel and accessories appropriate for your task and prepare for donning.
  • The first item to be worn is the legwear. Inspect the item for damages and stains and once satisfied sit on the “barrier” stool, if available, or on a chair or bench, and put on the first boot, taking care to ensure that it does not touch the floor. Then swing the clean foot over to the cleanroom side of the stool or bench. Put on the second boot and swing over fully to the cleanroom side and stand up.
  • Next put on your head cover, if necessary over the cap already on. Adjust to cover hair fully. Take care not to touch anything other than the items of garments.
  • Put on face mask, where applicable.
  • Now prepare the coverall for wearing it. Inspect for tears and soil, keeping it off the floor. Step into legs and then pull on the upper half. Tuck the skirt of the hood inside the collar of the coverall or coat. Close all fasteners at neck and wrists. Tuck legs of garment into boots and refasten legwear till it is snug and comfortable.
  • Discard gowning gloves, if worn. Disinfect hands as perprocedure prescribed by your SOP. Put on working gloves using the same technique and care described earlier for donning gloves. Tuck cuffs of garment into gloves.
  • Check that all leg, and arm openings are completely sealed with gloves and boots.
  • Do not adjust garment after donning working gloves. As a matter of fact your gloved hand should now touch only your work related objects and nothing else.
  • Proceed through air shower and across another tacky mat to enter the cleanroom.

 

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Hand decontamination and use of gloves

The wearing of rubber gloves is by itself an aseptic measure, minimizing the risk of direct contact contamination of sterile equipment and processes. However, some contamination can occur through torn gloves or through invisible small holes that appear in about 20% of gloves during use, and also through moisture on sleeves of cotton gowns. For these reasons scrubbed operators should use an antiseptic skin preparation.

Effective preparations are:
1. Certain detergent antiseptic solution containing, for example, 1% Chlorhexidine or 1% Povidone Iodine applied vigorously to fingers, hands, and forearms for 2-3 minutes with running water and no brush, followed by rinsing and drying
2. 10 ml of 70% Ethanol or 60% Isopropanol containing Glycerol (1%) and, for even greater antiseptic activity, Chlorhexidine (0.5%), but no water. Rub vigorously on to fingers, hands and forearms until they are dry.

Repeated use of these agents has a cumulative effect due partly to residues of antiseptic left on the skin, which prevent the build-up of bacterial flora on the gloved hand. A detergent must be used to remove physical contaminants. The under surfaces of fingernails should be cleaned, when necessary, with a scraper. Hands must be washed with an antiseptic detergent preparation, and fresh gloves must be put on. If gloves are sterilized and re-used they must be tested for holes by inflation underwater. Rings should be removed before preparation of hands. Use of brushes is generally discouraged, because they are in turn so difficult to clean and disinfect. Besides, over enthusiastic scrubbing can cause the skin oils to be removed to such an extent that it tends to flake and slough off, emitting particles that may be or not carry transient or resident microflora. The choice of detergent and antiseptic will determine how effective your hand wash process is.

The objective should be clean and sanitise the skin before donning sterile gloves, which acts as the final barrier. When hands are clean, the burden on the gloves as protective gear diminishes.

 


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