As working in the operating theatre calls for maximum concentration for often for several hours at a time, a commissioned project at the Hohenstein Institute looked at the question of the effect that the clothing worn in the operating theatre has on the surgeons' ability to concentrate.

The Hohenstein researchers used a computer-based occupational psychology test which enabled them to measure and record the ability of the surgeons to concentrate. This means that for the first time it was possible to assess the effect of clothing systems on the performance of their wearers not simply from secondary data but by directly measuring their mental abilities in a realistic simulation of the actual work that goes on in the operating theatre.

Standard requirements

For their own protection and to protect the patient, surgeons at work wear special operating theatre clothes which have to meet certain standard requirements, for example EN ISO 13795. For example, an operating theatre coat must provide an effective barrier against blood and bacteria. At the same time, the protective clothing must hinder the surgeon as little as possible in his work, because in the operating theatre the safety of the patient always takes precedence.

"Hospitals currently employ two different strategies. Some institutions use disposable operating theatre clothing, which is destroyed after each use, while in other hospitals surgeons wear reusable clothing systems which are cleaned after being worn. When operating theatre clothing is being selected, its effect on the work of the wearer, and therefore on patient safety, should be the top priority, along with ecological and economical aspects," the Hohenstein Institute says.

The volunteers in the joint study by the Hohenstein Institute and two companies from Switzerland, the textile manufacturers Rotecno AG and Hälg Textil AG, which specialises in operating theatre textiles, experienced for themselves just how tiring highly focused concentration over a long period can be for the surgeons. They are said to have emerged completely exhausted from the simulated operating theatre, which was kept at a pleasantly cool temperature.

Influence of external parameters like clothing

"Maintaining one's concentration for several hours is a tremendous physical and mental strain which can be greatly influenced by external parameters like clothing," said Prof. Dirk Höfer, Head of the Institute for Hygiene and Biotechnology at Hohenstein.

That is why the researchers measured whether the reaction speed and error rate for the ‘volunteer surgeons' were affected by wearing disposable or reusable clothing in operating theatre conditions. First of all, the volunteers had to perform a challenging microsurgical task requiring a lot of concentration, in a specially developed ‘Stress box'.

Results

After the stress phase, both the focused concentration and the ability of the volunteers to multitask were measured. The results show that the scientists were able to identify significant differences in the reaction time and error rate associated with the two clothing systems. The volunteers who were provided with high-quality reusable clothing generally performed better in the test than those wearing simple disposable clothing.

This was reflected firstly in a quicker reaction time to optical and acoustic stimuli and secondly in a lower error rate. Both parameters have a crucial effect on performance and so, potentially, on the success of a surgical intervention.

According to the researchers, this textile-related factor has not been considered before, but in real life it could make the vital difference between the success and failure of an operation.

"Now, thanks to the Hohenstein test system, reliable data can be collected about the effect of textiles on mental performance which can be used to provide a scientific basis for decision-making by hospitals and the pharmaceutical industry and also by the armed forces, professional athletes and the aviation industry," the researchers say.

According to the Hohenstein the results also point to an urgent need for further research, especially in jobs with a high degree of responsibility, where existing clothing systems should be tested with regard to mental performance, and improved with that specific purpose.

Further information:

Prof. Dirk Höfer

Institute for Hygiene and Biotechnology at the Hohenstein Institute

[email protected]