Scrubs: a tale of surgical attire

Medical/Surgical Operative Photography

Medical staff wear specially designed clothing to reduce the spread of disease in hospital settings. However, this wasn’t always the case, as up until the late 1800s most doctors performed surgery whilst dressed in ordinary clothing. The “scrubs” – so called because they are worn by those who have “scrubbed up” to prepare for surgery – that we see today didn’t appear until well into the 20th century.

For centuries doctors wore ordinary clothes in operating theatres and worked bare handed with non-sterile instruments. Having to wear special surgical attire was unpopular as uniforms were associated with the lower classes, but by the 1890s surgeons started to wear surgical gowns over their clothing to protect them from bloodstains. Yet these garments did little to reduce the spread of disease as they were rarely washed and usually stained with flecks of dried blood and pus.

After World War One and the outbreak of Spanish influenza in 1918, growing acceptance of the germ theory of disease meant surgeons and their assistants began to wear gowns, caps, rubber gloves and gauze masks. However, these practices were not universally adopted and the purpose of these measures was primarily to protect surgeons from catching diseases from their patients rather than for the prevention of intra-operative infections. It wasn’t until several decades later that medical professionals began to pay greater attention to maintaining a sterile environment.

By the 1940s, advances in aseptic techniques and better understandings of the aetiology of wound infection meant that more stringent measures were put into place to reduce the spread of germs in operating theatres. Instruments and dressing were routinely sterilised with steam and having standard surgical attire became regarded as an important way to prevent post-operative infections. White was associated with sterility and cleanliness and was used for surgical gowns until it was found that the glare it caused under the bright theatre lights created eye strain for surgeons. By the 1950s, most hospitals has switched to surgical attire in jade green or ceil blue instead as those colours reduce eye fatigue and provide a high contrast against the reddish colours of body tissues and blood.

Two-piece outfits consisting of a tunic shirt and pants were introduced in the 1960s and 1970s and have remained largely unchanged since that time. Worn by both men and women, scrubs are designed to be comfortable, durable and wrinkle resistant.  Their simple design aims to limit the places that pathogens can proliferate and the cotton/polyester blend of the fabric is able to withstand laundering at high temperatures for sterilisation purposes. Scrubs are also cheap enough to be easily replaced if they become badly stained or contaminated. The medical attire worn nowadays has come a long way from the unsanitary surgical practices of previous centuries.

Image credit

Ooi, P. (2012). Medical/surgical operative photography [Image]. Retrieved from https://www.flickr.com/photos/phalinn/8116024703

References

Belkin, N. L. (1998). Surgical scrubs – where we were, where we are going. Today’s Surgical Nurse, 20(2), 28-34.

Houweling, L. (2004). Image, function, and style: A history of the nursing uniform. American Journal of Nursing, 104(4), 40-48.

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