Perspectives on barrier material standards for operating rooms.

Identification of standard tests for assessing barrier performance of surgical gowns and drapes has been an illusive goal. Although surgical procedures have been described as early as 1653 when the illustrated surgical methodology for craniotomy was published, documentation of the use of surgical gowns has had to be determined by paintings and photographs. One of the first depictions of the use of surgical gowns appears in an 1889 oil painting by Thomas Eakins displaying a surgical theater in the University of Pennsylvania. Most of the early research on barrier materials was performed by Dr William Beck. In 1952, Beck published his classic paper ‘‘False Faith in the Surgeon’s Gown and Surgical Drape,’’ demonstrating that cotton cloth when wet transports bacteria from a nonsterile to a sterile area. In 1963, Beck and Carlson defined an aseptic barrier as a ‘‘material placed between an aseptic area, such as an operative incision, and areas which harbor microorganisms with the purpose of preventing the spread of bacteria into the sterile zone.’’ Beck’s work demonstrated that the wicking action of the cotton drapes was so great that microorganisms traveled almost instantaneously in both directions through these materials. After World War II, Quarpel (Quartermaster Corp, Philadelphia, Pa), an extremely fine, all-pima cotton treated with a water-repellent finish, became available to the health care market. Research published in 1967