Surgical Gown Protocols in Thoracic Surgery

The Controversy Surrounding Surgical Gowns

Dear Sir/Madam,
I am very pleased to have discovered this webpage, as it finally provides me with someone who can help clarify my confusion.
Recently, I underwent a thoracoscopic surgery at a rather subpar hospital.
The nurse handed me a surgical gown and instructed me to wear it backward.
However, no matter how I adjusted it, it felt like it couldn't adequately cover my body, and I was also not allowed to wear any underwear.
I discussed with the nurse the possibility of wearing my underwear or wearing the gown the correct way, but this led to an unpleasant situation, and even my mother said I was in the wrong, which really upset me.
Could you please explain why patients undergoing thoracic surgery are not allowed to wear underwear, and why the gown, which has an opening in the front, needs to be worn backward? I assure you that I was not being unreasonable; it was just very difficult for me to go down to the operating room on the third floor in that situation.
Thank you for your understanding and for helping me make sense of this.
Sincerely,
A high school sophomore
May 13, 2003

keith, 10~19 year old female. Ask Date: 2003/05/14

Dr. Yang Wenda reply Pulmonology

Dear high school sophomore,
The surgical gown is a garment provided to patients to wear temporarily before surgery, serving both to maintain privacy and to provide warmth.
Personal undergarments will still need to be removed in the operating room (and you'll need a bag for them), as the surgical site requires disinfection (which extends well beyond the wound area).
During surgery, some blood or irrigation fluids may also soil the undergarments, and the operating room is a highly sterile environment where personal items that have not been disinfected are not suitable to bring in.

Typically, the operating room is equipped with sterilized drapes to cover non-surgical areas, including the lower body.
The reason for wearing the surgical gown backward is to facilitate the staff in removing it while you are lying flat (including when you are unable to move your body after anesthesia).
This also allows for the gown to be put back on after surgery without disturbing the surgical site, ensuring your privacy and warmth.
Your concerns are valid; however, the medical staff may be too busy to explain everything in detail.
Although I am not a surgeon, I hope to share this information to help you feel more at ease.
Wishing you good health and success in your studies!

Reply Date: 2003/05/14

More Info

Dear High School Student,
Thank you for reaching out with your concerns regarding the surgical gown protocols in thoracic surgery. I understand that your experience during your recent procedure was frustrating, and I appreciate the opportunity to clarify some of the protocols involved.

First and foremost, the requirement to wear a surgical gown in a specific manner—often with the opening in the back—serves several important purposes in the surgical setting. The primary goal is to maintain a sterile environment. In surgeries, especially those involving the thoracic cavity, it is crucial to minimize the risk of infection. The surgical gown is designed to cover as much of the body as possible, and wearing it backward helps ensure that the sterile side remains uncontaminated by contact with non-sterile surfaces, such as your skin or clothing.

Regarding the prohibition on wearing undergarments, this is also tied to the need for sterility. Underwear can harbor bacteria and other pathogens, which could potentially be introduced into the surgical site. By requiring patients to wear only the surgical gown, the surgical team can better control the sterile field and reduce the risk of postoperative infections.

I understand that the gown may not have felt comfortable or secure, and this can be a common concern among patients. Hospitals often have specific protocols that may not take individual comfort into account, focusing instead on the overarching need for sterility and safety. If you felt uncomfortable, it would have been appropriate to express your concerns to the nursing staff or the surgeon prior to the procedure. They might have been able to provide alternatives or at least explain the reasoning behind the protocols more thoroughly.

It’s also important to remember that surgical teams are trained to prioritize patient safety above all else. While it may feel inconvenient or uncomfortable, these protocols are in place to protect you during surgery. If you have further concerns about your experience, I encourage you to discuss them with the healthcare provider or patient advocate at the hospital. They can provide additional insights and may be able to address your concerns about comfort and communication in the surgical setting.

In conclusion, while your discomfort is valid, the protocols regarding surgical gowns and the prohibition of undergarments are rooted in the necessity of maintaining a sterile environment during surgery. I hope this explanation helps clarify the rationale behind these practices. If you have any more questions or need further assistance, please don’t hesitate to reach out.

Best wishes for your health and well-being,
Doctor Q&A Teams

[Your Institution/Organization]

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