- Written by Rich Fitzmorris
Question: How Do You Prevent Pilling and Linting On Operating Room Towels?
Answer: RICHMOND, VA -- Some hospital and commercial laundries are continuing to experience problems with the linting and pilling of certain types of operating room towels.
The linting and pilling poses not only a problem of quality control for laundry managers, but an issue for surgeons concerned over the potential for surgical wound infections.
The problem was most recently reported by Keith Nichols, who manages Handcraft Services, a commercial laundry based in Richmond, VA. Nichols reported experiencing a problem with pilling and fiber lint from the jade green fabric of his operating room towels, which are made of 100 percent cotton and are domestically manufactured
While a number of sources cited mechanical action and abrasion as a primary cause of pilling, a consensus of expert opinion attributed the linting problem in OR towels to an inferior quality of cotton product used in fabrication of these items.
"The most common problem is short-staple cotton," said John Urquhart, General Manager of Unichem Corporation in Chicago. "The term `Made in the U.S.A.' doesn't mean that the cotton was milled in the U.S.A. and does not mean that it's good cotton. Short-staple cotton loosens and breaks more readily than long-staple cotton. It lints and pills, if not in the first wash, then in the second, or third, or fourth, or fifth. The short fibers loosen and come out faster. You wind up with lint."
Pomerantz agreed that short-staple cotton increases the likelihood of lint problems in cotton OR products.
Establishing Probable Cause
"The first thing management should do is take a test from the towel or from the residue in the wash wheel and consult the manufacturer of the product," said Pomerantz.
In the past, said Pomerantz, whenever customers of his company have had any type of problem with any product, the company has asked them to send in a sample of the product.
"We then send the product to two test services--one at the mill, the other at a test lab. You then compare the results. You gather all the necessary information and then come to a conclusion."
Pomerantz also encouraged laundry managers who are experiencing this problem to check their wash formulas.
Urquhart emphasized that several other problems may account for premature degradation of the OR towels. These factors include overbleaching, underloading of textiles in washers, and overwashing in long cycles.
The Over and Under of Washing
Standard industry tests would determine whether the problem originates with short-staple cotton fibers, or perhaps chemical damage from overbleaching, or excess mechanical action, said Lynn Olsen, senior scientist for the Ecolab Inc.--Textile Care Division. Minimizing the latter two elements is an important key.
"Mixed loads also produce more linting," said Olsen. "If you're washing surgical drapes six feet long by three feet wide, there would also be cause for concern that there's too little mechanical action for the goods."
Although mechanical action is frequently cited as a cause of pilling, laundry managers who are experiencing a problem should check their washers for residual traces of bleach, said Eric Frederick, General Manager of HGA Laundry, a major central laundry located in Madison, AL.
The control of lint is a function of proper sorting and washing procedures, said Frederick.
"If there's a bleach residue," said Frederick, "you can see it pretty quickly and easily."
Identifying the Culprit
If the fabric washes well the first few times, but then degrades within the first 15 to 20 washes, it may be indicative of a chemical problem, said Frederick.
"If the fabric falls apart after two or three washings," said Frederick, "then you know it's the fabric. If the towel is the problem, there's nothing you can do about it. It's a cheap towel. Some towels are so poorly made with short-staple cotton that there's nothing you can do but throw them away. But they do make good wipes, or industrial shop towels."
Laundry managers who are experiencing a problem with severe linting of OR towels at an early stage in the product's life cycle "should probably avoid" the use of such products, said Dr. Belkin, Ph.D., a healthcare consultant who has published articles on the topic of linting and the incidence of surgical wound infections.
Heading for Trouble
All industry observers agreed that there is a need to test the tensile strength and properties of these OR towels under the conditions of test laboratories. They recommended sending samples of the items to the International Fabricare Institute in Silver Spring, MD, at (800) 638-2627, or (301) 622-1900; the National Association of Institutional Linen Management in Richmond, KY, at (800) 669-0863, or (606) 624-0177; or Dr. Charles Riggs at Texas Woman's University in Denton, TX, at (940) 898-2760.
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