ROANOKE, Va. — This month, I will continue on the topic of wash formulas, writing specifically about reusable barrier surgical linen and incontinent pads. The new-generation surgical linen poses a special challenge for laundry managers.
It is lightweight and 100% polyester. It is often soiled with mineral oil or body fat from various surgical procedures. The wrappers often have autoclave tape still attached to them when they arrive in the laundry.
Reusable surgical linen and isolation gowns are best processed through a conventional washer-extractor rather than through a tunnel washer. This preference is based on the unique wash formula I have developed to process these items.
Determining the proper load size for the new barrier surgical linen is important. As such, I find it extremely helpful if the conventional washer has a window as part of its front door. It is also important to get good mechanical action while washing the surgical linen.
The difference between underloading the washer and overloading it can be as little as 5 pounds of product. Underloading will result in the linen floating on top of the water, with little mechanical action. Overloading will prevent the surgical linen from tumbling in the washer and, in extreme cases, may prevent water and chemicals from getting to the center of the load. As a general rule, the goods should be loaded to between 70% and 75% of the rated capacity of the washer.
The focus of washing this new polyester surgical linen is to remember that less is more. High amounts of alkalinity—measured in parts per million—will damage the linen and shorten its life. The No. 1 challenge is to effectively remove oils and body fats from the fabric without using a traditional surgical wash program. I have found that following this “less is more” philosophy has helped my laundry to fully embrace this new fabric and make its use cost-effective.
A two-minute rinse at the start of the formula helps remove loose soil and wet down the fabric. This is followed by a break with very little alkali and a reasonable amount of a solvent-based detergent; the latter helps remove the oils, fats and residual autoclave tape. This is followed by a series of rinses and an intermediate extract. (You should not use bleach or softener on this type of fabric. Softener will leave oily-looking spots.) A final rinse utilizes a little bit of sour and a product designed to rejuvenate the barrier of the fabric.
Incontinent pads also are a special challenge. By the very nature of the product, the bioburden on the pads can be awfully high. The length of time it takes for the used pad to arrive in the laundry can also add to the challenge of effectively washing this product. Proper load size is again a critical element in washing, because effective mechanical action is a key to getting a clean, odor-free product.
An additional challenge with incontinent pads is the frequent placement of EEG/EKG stickers on the pads. The highly aggressive adhesive on the back of those patches will not come off during a normal processing cycle. I recommend the use of a solvent-based detergent to help remove the stickers from the pad during washing. As with the reusable surgical linen, no softener should be used on the pads, as doing so will greatly reduce a pad’s ability to absorb water. A high concentration of bleach (I recommend hydrogen peroxide) will help remove any odors from the pads.
Next month, I will finish up this section by analyzing barrier retreatment products.