Reusing sterile gowns and drapes saves money and spares the environment, but it poses additional infection control challenges. Here are 3 tips for ensuring the integrity and sterility of reusable surgical textiles.

Know the standards. Before you switch to reusable textiles, learn what goes into the process of taking a used gown or drape and preparing it for reuse in a sterile environment. Hospitals with in-house laundry services and third-party healthcare launderers must abide by certain industry standards for laundering surgical textiles. The infection control person in your facility should become familiar with the 2 documents from the American National Standards Institute and Association for the Advancement of Medical Instrumentation that experts say are the best practices for the preparation and sterilization of reusable surgical textiles:

• ANSI/AAMI ST65:2008. "Processing of reusable surgical textiles for use in health care facilities" is the signature document governing the processing of reusable surgical textiles. This comprehensive document covers every aspect of the laundry process, leading to the point of surgical pack preparation, and also discusses how those packs are to be sterilized before use in the operating room.
• ANSI/AAMI ST79:2010. "Comprehensive guide to steam sterilization and sterility assurance in health care facilities" also covers sterilization processes.

Choose the right laundry service. Understanding the standards governing surgical textile laundering helps you to make a more informed decision about which laundry service to hire, as most smaller facilities and even many hospitals will contract with a third-party launderer to clean reusable gowns and drapes. The Healthcare Laundry Accreditation Council (HLAC) is a non-profit organization dedicated to the inspection and accreditation of healthcare laundering facilities. HLAC accreditation is voluntary, so lack of accreditation doesn't necessarily mean a laundry facility isn't in compliance with standards. But as with hospital and surgery center accreditation, HLAC accreditation can be an easy way for you to identify facilities that have proven their adherence to best practices and recommendations for the proper laundering of reusable surgical textiles. The 2011 edition of the HLAC standards was released as a free download on the HLAC website last month (www.hlac.org). This latest edition includes new material (Part III) that addresses pack-room issues and will essentially reflect all the standards in ANSI/AAMI ST65:2008.

Ask prospective laundry services to provide references and to let you tour their facilities. Familiarize yourself with the standards ahead of time so you know what questions to ask and how to accurately judge the processes and quality controls the laundry service has in place. Make sure the laundry service is specifically equipped to handle surgical textiles, which are subject to more rigorous standards than other healthcare textiles because textile quality and integrity at the sterile field are important factors in ensuring patient safety during surgery.

Prep, pack and sterilize thoroughly. Although still in the minority, healthcare launderers offering pack-room services are growing in number. In addition to the laundering process, these contractors will handle the inspection, quality assurance testing, preparation and packing of laundered surgical textiles for you. The textiles are then returned to your facility as wrapped packs ready for the final step: sterilization. Healthcare laundries that provide this service remove the burden from your staff to inspect laundered textiles for holes or tears and then fold and bundle them properly for sterilization. But the laundries must be able to show that they adhere to the same pack-room standards by which healthcare facilities' sterile processing departments abide.

If you don't contract with a laundry that provides these pack-room services, you'll need to train and monitor in-house staff to ensure they're inspecting and packing reusable textiles properly before sterilization. Again, use ANSI/AAMI ST65:2008 and ST79:2010 as your guiding documents, and be sure to have a copy of these standards available to staff in the sterile processing department at all times. You should also have a system in place for tracking how many times reusable textiles are being used and laundered, as they'll need to be discarded after a certain number of uses or when they develop irreparable holes and other flaws that compromise their integrity as a sterile barrier.