Scrubs (clothing)

Last updated
A light blue set of scrubs. A set of light blue scrubs.jpg
A light blue set of scrubs.

Scrubs, sometimes called surgical scrubs or nursing scrubs, are the sanitary clothing worn by physicians, nurses, dentists and other workers involved in patient care. Originally designed for use by surgeons and other operating room personnel, who would put them on when sterilizing themselves, or "scrubbing in", before surgery, they are now worn by many hospital personnel.

Contents

Their use has been extended outside hospitals as well, to work environments where clothing may come into contact with infectious agents (veterinarians, midwives, etc.). Scrubs are designed to be simple (with minimal places for contaminants to hide), easy to launder, and cheap to replace if damaged or stained irreparably. In the United Kingdom, scrubs are sometimes known as theatre blues.

The spread of methicillin-resistant Staphylococcus aureus (MRSA) has increased the use of scrubs but can give wearers a false sense of security that they are "clean" when in fact they are as easily contaminated as any other clothing. [1]

History of surgical attire

In contrast to the uniforms long required of nurses, [2] surgeons did not wear any kind of specialized garments until well into the 20th century. [3] Surgical procedures were conducted in an operating theater. The surgeon wore their own clothes, with perhaps a butcher's apron to protect their clothing from blood stains, [4] and they operated bare-handed with non-sterile instruments and supplies. (Gut and silk sutures were sold as open strands with reusable hand-threaded needles; packing gauze was made of sweepings from the floors of cotton mills.)[ citation needed ]

In contrast to today's concept of surgery as a profession that emphasizes cleanliness and conscientiousness, up to the early 20th century the mark of a busy and successful surgeon was the profusion of blood and fluids on their clothes. [5] The importance of dress as a badge of one's class in society was paramount and the processes behind the transmission of infection were the subject of controversy within the profession.[ citation needed ]

With the "Spanish flu" pandemic of 1918 and the growing medical interest in Lister's antiseptic theory, some surgeons began wearing cotton gauze masks in surgery; however, this was not to protect the patient from intra-operative infection, but to protect the surgeon from the patient's diseases. Around the same time, operating theatre staff began wearing heavy rubber gloves to protect their hands from the solutions used to clean the room and equipment, a practice surgeons grudgingly adopted.

In the early 20th century a doctor chose to wore a green scrub instead of white. Use of the color blue followed suit and became more commonplace afterwards. [6]

By the 1940s, advances in surgical antisepsis (now called aseptic technique) and the science of wound infection led to the adoption of antiseptic drapes and gowns for operating room use. Instruments, supplies and dressings were routinely sterilized by exposure to either high-pressure steam or ethylene oxide.

Originally, operating room attire was white to emphasize cleanliness. However, the combination of bright operating lights and an all-white environment led to eye strain for the surgeon and staff. By the 1950s and 1960s, most hospitals had abandoned white operating room apparel in favor of various shades of green, which provided a high-contrast environment, reduced eye fatigue, and made bright red blood splashes less conspicuous.[ clarification needed ]

By the 1970s, surgical attire had largely reached its modern state—a short-sleeve V-necked shirt and drawstring pants or a short-sleeve calf-length dress, made of a cotton or cotton/polyester blend. Over this was worn a tie-back or bouffant-style cloth cap, a gauze or synthetic textile mask, a cloth or synthetic surgical gown, latex gloves, and supportive closed-toe shoes. This uniform was originally known as "surgical greens" because of its color, but came to be called "scrubs" because it was worn in a "scrubbed" environment.

Use

American hospital workers at R Adams Cowley Shock Trauma Center at University of Maryland Medical Center in Baltimore, Maryland wearing scrubs in 2001 Shock Trauma Pic.jpg
American hospital workers at R Adams Cowley Shock Trauma Center at University of Maryland Medical Center in Baltimore, Maryland wearing scrubs in 2001

In many operating rooms, it is forbidden to wear any exposed clothing, such as a t-shirt, beneath scrubs. As scrubs are designed to promote a clean environment, the wearing of outside clothing is thought to introduce unwanted pathogens. Nearly all patient care personnel at hospitals in the United States wear some form of scrubs while on duty, as do some staffers in doctor, dental, and veterinary offices.

Doctors in the United States may wear their own clothes with a white coat except for surgery. Support staff such as custodians and unit clerks also wear scrubs in some facilities. When the physician is not performing surgery, the scrub is often worn under a white coat.

In England, all NHS hospital trusts have stringent clothing policies, and many of these specifically forbid wearing the iconic white coat for medical staff, owing to infection control concerns. This has meant that several hospitals around the UK have opted for scrubs for staff, especially in Accident and Emergency departments.

Scrubs are also sometimes used as prison uniforms in the U.S. and other countries.

Outside of hospitals, scrubs are becoming more common in other areas especially in light of the global COVID-19 pandemic. Non-traditional industries using scrubs include workout facilities, schools, [7] [8] [9] and restaurants. Health and safety standards are critical to restaurants' success and legal compliance, and there are many opportunities for bacteria to thrive and spread via menus, tables, and shared condiment shakers. [10] [11]

Modern scrubs

Today, any medical uniform consisting of a short-sleeve shirt and pants is known as "scrubs". Scrubs may also include a waist-length long-sleeved jacket with no lapels and stockinette cuffs, known as a "warm-up jacket".

Colors and patterns

A scrub top Scrubtop.JPG
A scrub top
Scrub trousers Scrubbottom.JPG
Scrub trousers

Scrubs worn in surgery are almost always colored solid light grey, light green, light blue or a light green-blue shade.

Green scrubs are commonly chosen because green is the opposite of red on the color wheel, which helps doctors avoid visual fatigue and desensitization to the red and pink hues of blood and organs during operations. Blue is also a popular choice for the same reasons. Both colors prevent optical illusions, such as afterimages, which may occur from staring at red or pink for extended periods of time. This shift in colour perception allows medical professional to avoid visual confusion when looking at white surfaces or objects like drapes or other uniforms. [6]

Non-surgical scrubs come in a wider variety of colors and patterns, ranging from official issue garments to custom made, whether by commercial uniform companies or by home-sewing using commercially available printed patterns. [12]

Some hospitals use scrub color to differentiate between patient care departments (i.e., Surgery, Childbirth, Emergency, etc.) or between licensed patient care personnel (nurses, radiologic technologists, respiratory and physical therapists, etc.), unlicensed assistive personnel, and non-patient care support staff (i.e., portering, dietary, unit clerks, etc.). Hospitals may also extend the practice to differentiate non-staff members/visitors.

In England and Wales many NHS trusts use different colored scrubs to distinguish between different branches of healthcare professionals, for example anaesthetists may wear maroon. This allows staff and patients to easily spot the workers they are looking for in a high-pressure situation. Piping of different colors or pattern are also often used to distinguish seniority. Many hospitals have posters in reception areas explaining this system but it is mainly designed for hospital staff.

Custom-made printed scrub tops, featuring cartoon characters and cheerful prints, are common in pediatricians' offices, veterinary offices, dental clinics and children's hospitals, and prints for various holidays can be seen throughout the year. Some acute care facilities or larger hospitals also have relaxed rules regarding the wear of non-regulation scrubs in non-surgical units, and they are no longer just the classic v-neck scrub tops, but are now offered in many styles and patterns.

The scrub industry, much like maternity wear, used to have very limited fashion options. Indeed, scrubs were generally box shaped and ill fitted, often with limited design choices. Over the past 10 years the scrub industry has taken notice of the individual preferences of medical professionals and have begun to design and manufacture fashionable and unique designs. [13]

Cleaning

January 2015 laundry service in a medical facility in Sierra Leone. The scrubs are cleaned in-house to prevent the spread of disease. Laundry that helps to saves lives in the fight against Ebola (16154988230).jpg
January 2015 laundry service in a medical facility in Sierra Leone. The scrubs are cleaned in-house to prevent the spread of disease.

Surgical scrubs are not generally owned by the wearer. Due to concerns about home laundering and sterility issues, these scrubs are usually hospital-owned or hospital-leased through a commercial linen service. And due to these laundering and sterility limitations, disposable scrub suits were introduced in the market.

Accessories

Scrub caps

Scrub caps have graduated from being functional to also being a personalized accessory both in the operating room and outside. Before the antiseptic focus of the 1940s, hats were not considered essential to surgery. From the 1940s through the 1950s, as a hygienic focus swept the industry, hats became standard wear to help protect patients from contaminants in hair. Full-face hats were even designed for men with beards. These hats have been and continue to be distributed by group purchasing organizations (GPOs) who supply hospitals with most equipment.

In the medical fashion "revolution" of the seventies, more and more medical professionals began personalizing their scrubs by either sewing their own hats or buying premade hats made of colorful patterned fabric. Several styles were popular, including the "bouffant" surgical cap, a utilitarian hairnet-like hat which typically comes in light blue, and the "milkmaid", a bonnet-like wrap around hat.

Bouffant surgical caps are perhaps the most widely used scrub hats in hospitals, and their usage is not limited to only nurses and surgeons: hospital patients are required to wear a bouffant cap when having surgery of any kind.

In 2016, a controversy emerged in the US around the use of cloth or disposable surgical caps vs mandatory use of bouffant style surgical caps. [14] This controversy ended in state mandates for the use of bouffant caps to comply with Joint Commission standards. [15] [16]

Over time, other styles such as the ponytail scrub cap, designed to secure long hair with an elastic pouch at the back, and the pixie scrub cap, which offers a close-fitting design for shorter hair, have also been widely used to provide different fittings. [17] [18]

Sterile hijab

Some Muslim women prefer to keep wearing their hijab while working in the operating theatre. Hospitals in the UK and the US began providing disposable hijabs as an alternative to surgical caps. [19]

Shoe covers

Shoe covers are used to maintain a sterile environment in operating rooms, and other healthcare settings. They help prevent the transfer of contaminants from the outside environment into sterile areas by covering the shoes of medical staff and visitors. [20] [21]

They are typically made from lightweight, disposable materials such as polypropylene, polyethylene, or non-woven fabric. These materials are selected for their durability, resistance to moisture, and ease of disposal.

See also

Related Research Articles

<span class="mw-page-title-main">Uniform</span> Similar clothing worn by a group of people

A Uniform is a variety of costume worn by members of an organization while usually participating in that organization's activity. Modern uniforms are most often worn by armed forces and paramilitary organizations such as police, emergency services, security guards, in some workplaces and schools, and by inmates in prisons. In some countries, some other officials also wear uniforms in their duties; such is the case of the Commissioned Corps of the United States Public Health Service or the French prefects. For some organizations, such as police, it may be illegal for non-members to wear the uniform.

<span class="mw-page-title-main">Surgery</span> Medical procedures that involve incisive or invasive instruments into body cavities

Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions, to alter bodily functions, to reconstruct or improve aesthetics and appearance, or to remove unwanted tissues or foreign bodies. The subject receiving the surgery is typically a person, but can also be a non-human animal.

<span class="mw-page-title-main">Nurse uniform</span> Traditional professional nursing uniform

A nurse uniform is attire worn by nurses for hygiene and identification. The traditional nurse uniform consists of a dress, apron and cap. It has existed in many variants, but the basic style has remained recognizable.

<span class="mw-page-title-main">Hospital volunteer</span> Volunteers in hospitals who work without pay

Hospital volunteers, also known as candy stripers in the United States, work without regular pay in a variety of health care settings, usually under the direct supervision of nurses.

<span class="mw-page-title-main">Operating theater</span> A room in a hospital in which surgeries are performed

An operating theater is a facility within a hospital where surgical operations are carried out in an aseptic environment.

<span class="mw-page-title-main">Medical glove</span> Single-use glove worn during medical examinations and procedures

Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl chloride and neoprene; they come unpowdered, or powdered with corn starch to lubricate the gloves, making them easier to put on the hands.

<span class="mw-page-title-main">Surgical technologist</span> Profession

A surgical technologist, also called a scrub, scrub tech, surgical technician, or operating department practitioner or operating room technician, is an allied health professional working as a part of the team delivering surgical care. Surgical technologists are members of the surgical team. The members of the team include the surgeon, surgeon's assistant, circulator nurse and anesthesia provider. They possess knowledge and skills in sterile and aseptic techniques. There are few mandatory professional requirements for surgical technologists, and the scope of practice varies widely across countries and jurisdictions. Surgical technologists attend junior colleges and technical schools, and many are trained in military schools. In the military they perform the duties of both the circulator and the scrub. The goal is for surgical technologists to be able to anticipate the next move the surgeon is going to make in order to make the procedure as smooth and efficient as possible. They do this by having knowledge of hundreds of surgical procedures and the steps the surgeon needs to take in order to complete the procedure, including the very wide range of surgical instruments they may need. Specialties can include, but are not limited to, the following: genitourinary, obstetrics and gynaecology, urology, ENT, plastics, general, orthopedics, neurology, and cardiovascular. They only work in surgical or perioperative areas and are highly specialized. Surgical technologist is the proper term for a two-year program which earns a degree in applied sciences. The profession is up and coming and highly in demand.

TLC is a darkly surreal farce-like sitcom set in a fictional NHS hospital called South Middlesex. Written by Fintan Coyle, co-creator of hit game show Weakest Link, it was first broadcast on the BBC on 11 November 2002 and ran over six episodes until 16 December. There were some very mixed opinions on the show among both critics and viewers, but it achieved decent ratings and featured an excellent comedy cast including Richard Griffiths, Alexander Armstrong and The League of Gentlemen's Reece Shearsmith. The series was released on DVD in the UK on 29 October 2007.

<span class="mw-page-title-main">Asepsis</span> Absence of disease-causing microorganisms

Asepsis is the state of being free from disease-causing micro-organisms. There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is derived from the older antiseptic techniques, a shift initiated by different individuals in the 19th century who introduced practices such as the sterilizing of surgical tools and the wearing of surgical gloves during operations. The goal of asepsis is to eliminate infection, not to achieve sterility. Ideally, a surgical field is sterile, meaning it is free of all biological contaminants, not just those that can cause disease, putrefaction, or fermentation. Even in an aseptic state, a condition of sterile inflammation may develop. The term often refers to those practices used to promote or induce asepsis in an operative field of surgery or medicine to prevent infection.

<span class="mw-page-title-main">White coat</span> Coat worn by medics and scientists

A white coat, also known as a laboratory coat or lab coat, is a knee-length overcoat or smock worn by professionals in the medical field or by those involved in laboratory work. The coat protects their street clothes and also serves as a simple uniform. The garment is made from white or light-colored cotton, linen, or cotton polyester blend, allowing it to be washed at high temperature and making it easy to see if it is clean.

In the United Kingdom, operating department practitioners (ODPs) are allied healthcare professionals who are involved in the planning and delivery of perioperative care. As the name suggests, they are primarily employed in surgical operating departments, but they may also work directly within a variety of acute clinical settings, including pre-hospital emergency care, emergency departments, intensive care units (ICUs), endoscopy suites, interventional radiology, cardiac catheter suites, obstetric theatres and reproductive medicine.

<span class="mw-page-title-main">Forward surgical teams</span> Mobile medical units

In the United States Army, Medical Detachments, popularly known as Forward Surgical Teams (FST), are small, mobile surgical units. A functional operating room can be established within one and a half hours of being on scene and break down to move to a new location within two hours of ceasing operations.

A surgical nurse, also referred to as a theatre nurse or scrub nurse, specializes in perioperative care, providing care to patients before, during and after surgery. To become a theatre nurse, Registered Nurses or Enrolled Nurses must complete extra training. Theatre nurses can focus on different speciality areas, depending on which they are interested in.

<span class="mw-page-title-main">Nurse's cap</span> Traditional nurses hat

A nurse's cap or nursing cap is part of the female nurse's uniform, introduced early in the history of the profession. The cap's original purpose was to keep the nurse's hair neatly in place and present a modest appearance. Male nurses do not wear caps.

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anaesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.

Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff, as well as resident physicians in teaching hospitals.

<span class="mw-page-title-main">Women in nursing</span>

Historically, women have made up a large majority of the profession and academic discipline of nursing. Women's nursing roles include both caring for patients and making sure that the wards and equipment are clean. In the United States, women make up the majority of the field of nursing, comprising 86% of Registered Nurses (RNs) in 2021; globally, women comprise 89% of the nursing workforce.

<span class="mw-page-title-main">Xenco Medical</span> American medical technology company

Xenco Medical is an American medical technology company headquartered in San Diego, California that designs, develops, and distributes composite polymer medical devices.

David B. Hoyt, MD, FACS is the Past Executive Director of the American College of Surgeons. His tenure ended on Jan 1, 2022.

<span class="mw-page-title-main">Medical gown</span> Type of personal protective equipment worn by medical professionals

Medical gowns are hospital gowns worn by medical professionals as personal protective equipment (PPE) in order to provide a barrier between patient and professional. Whereas patient gowns are flimsy often with exposed backs and arms, PPE gowns, as seen below in the cardiac surgeon photograph, cover most of the exposed skin surfaces of the professional medics.

References

  1. ↑ Neely, A. N.; Maley, M. P. (2000). "Survival of Enterococci and Staphylococci on Hospital Fabrics and Plastic". Journal of Clinical Microbiology. 38 (2): 724–726. doi: 10.1128/JCM.38.2.724-726.2000 . PMC   86187 . PMID   10655374.
  2. ↑ Hardy, Susan and Corones, Anthony, "The Nurse's Uniform as Ethopoietic Fashion", Fashion Theory, Vol.21, No.5. (2015), pp. 523-552. doi : 10.1080/1362704X.2016.1203090.
  3. ↑ Hardy, Susan and Corones, Anthony, "Dressed to Heal: The Changing Semiotics of Surgical Dress", Fashion Theory, (2015), pp.1-23. doi : 10.1080/1362704X.2015.1077653.
  4. ↑ Stepchew, Dan. "The Origin of Scrubs". Medelita. Archived from the original on Apr 19, 2013. Retrieved 13 July 2011.
  5. ↑ Udin, Zaf (Feb 3, 2016). "Nursing Uniforms of the Past and Present". Pulse Uniform. Retrieved 14 November 2011.
  6. 1 2 Locke, Susannah F. (2013-01-31). "Why Do Doctors Wear Green Or Blue Scrubs?". livescience.com. Retrieved 2024-06-19.
  7. ↑ Breault, Joanna (Jul 30, 2020). "Should Teachers Be Allowed to Wear Scrubs?". We Are Teachers. Archived from the original on Jul 30, 2020. Retrieved 2020-05-18.
  8. ↑ Liou, Tiffany (July 16, 2020). "Teachers can wear scrubs when schools reopen in some Dallas County districts". wfaa.com. Retrieved 2021-12-01.
  9. ↑ Guidry, Leigh (Aug 3, 2020). "Lafayette Parish School System: Classroom teachers can wear scrubs this fall". Lafayette Daily Advertiser. Retrieved 2020-08-03.
  10. ↑ "How Antimicrobial Scrubs and Uniforms Can Keep Your Workplace Safe?". IQ Group. 14 November 2019. Retrieved 2020-05-18.
  11. ↑ "What are Antimicrobial Scrubs & Should You Buy Them?". Scrub Reviews. 2020-09-09. Archived from the original on Nov 30, 2020. Retrieved 2020-09-18.
  12. ↑ Raczka, Rachel Kim. "No stethoscope, no problem: This scrubs company could be your new favorite athleisure brand". Fast Company. Archived from the original on 16 August 2022. Retrieved 16 August 2022.
  13. ↑ Friedman, Vanessa (9 June 2021). "Health Care Workers Deserve Fashion, Too" . The New York Times. Retrieved 16 August 2022.
  14. ↑ Kowalczyk, Liz (2016-08-31). "No more surgical caps for surgeons?" . The Boston Globe. Archived from the original on Jul 16, 2023.
  15. ↑ Skeptical Scalpel (2016-04-26). "It's time to discuss surgeon headgear again".
  16. ↑ "Scrub Reviews: "Nurses, Don't Work Another Shift Until Youv'e Read This!"". ScrubReviews.com. 2020-08-12. Retrieved 2020-09-18.
  17. ↑ Rutherford, Colleen J. (2016-05-12). Surgical Equipment and Supplies. F.A. Davis. ISBN   978-0-8036-5795-3.
  18. ↑ "Surgical Scrubs Caps: What You Need to Know". Simply Scrubs Australia. 2022-01-16. Retrieved 2024-08-14.
  19. ↑ "Royal Derby Hospital: Disposable sterile hijabs introduced". BBC News. 17 December 2019.
  20. ↑ Rutherford, Colleen J. (2016-05-12). Surgical Equipment and Supplies. F.A. Davis. ISBN   978-0-8036-5795-3.
  21. ↑ Fuller, Joanna Kotcher; Fuller, Joanna Ruth (2012-11-07). Surgical Technology: Principles and Practice. Elsevier Health Sciences. ISBN   978-1-4557-2506-9.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.