The innovative effort is reimagining ways to protect patients’ body temperature before, during and after surgery.
A cross-disciplinary team of faculty and students with expertise in mechanical engineering, anesthesiology, textile design and textile technology seeks to mitigate the problem of patients facing hypothermia related to operating-room procedures.
What this team—led by associate mechanical-engineering professor Ryan Masoodi and anesthesiology specialist Dr. Adam Thaler—hopes to create is a garment they call the “gorilla gown.”
Surgery often requires general anesthesia which, in impairing the body’s autonomic temperature regulation, leaves patients at risk of a dangerously low body temperature as 90 percent of body heat loss occurs via radiation and convection through the skin. Hypothermia and core temperature drop leaves patients at risk of infection, increased blood loss and cardiac morbidity, thus affecting the body’s ability to heal, and potentially lengthening hospital stays.
When I had a chance to pick a senior design project, this had that tie-in to medicine, so it was a natural fit. –Jenna Yorko
The new, cost-efficient patient gown would provide thermal insulation before, during and after surgery, which is an important goal because current gowns have no thermal capability, according to the team.
“Perioperative hypothermia may produce several harmful effects, such as cardiac arrhythmias and ischemia, impaired renal function, poor wound healing and increased incidence of infection,” Dr. Adam Thaler says. “The objective of this research and design project is to create a new patient gown that reduces heat loss to maintain normothermia in the perioperative patient.”
The team also includes associate textiles professor Janet Brady, director of graduate engineering programs Brian George, Sidney Kimmel Medical College (SKMC) professor Dr. Marc Torjman, anesthesia resident Menachem Yondorf, mechanical engineering students Lexi Patania and Jenna Yorko, and recent textile materials technology alumna Mary O’Brien.
“Currently, we are developing a proposal to apply for a National Institutes of Health grant,” Masoodi shares. “The goal is to get external funding for three years to be able to complete this project.”
The current gowns don’t do anything to keep patients warm. The environment is cold before going into the operating room, and cold once in the operating room. –Dr. Adam Thaler
They have already researched current temperature-control items including the widely used 3M Bair Hugger, warming blankets, warming IV fluids and environmental modifications before testing current gowns and started work toward developing new materials. (The “gorilla gown” name—derived from the functionality of the design—is a nod to “bear hugger,” but the grant proposal defines the project as “developing a new generation of patient gowns to keep patients warm in the hospital and to reduce perioperative hypothermia.”)
Masoodi says the final design might be a multi-layered gown which includes an innermost layer with infrared material that reflects heat back onto the patient’s body, a non-woven fabric inner layer and woven polyester outermost layer. The gorilla gown could be either disposable or reusable.
“As a team of mechanical engineers and a textile materials technology major, we have the capability to design a new market-disrupting solution that provides greater thermal benefit to the wearer,” a pitch for the project reads. “If successful, this product has the potential to be implemented in the Jefferson Health System and expanded to operating rooms regionally, nationally and internationally.”
From the textiles perspective, O’Brien and other students worked to characterize current gowns in the Bruner Materials Characterization Laboratory, which is located in the new Ronson Health and Applied Science Center on East Falls Campus.
They evaluated construction, strength and thermal properties with the “Walking, Sweating Manikin” in an effort to obtain thermal and evaporative resistance data on the current gowns. This information will be used to develop the new gowns.
“Lexi, Jenna, and I were all tasked with researching hypothermia, the failure of autonomic body temperature regulation and current warming solutions,” says O’Brien, who contributed to the effort as part of her senior capstone. “Once we had a grasp on the full issue, and the ways in which it is being addressed, we then set about characterizing the current patient gown.”
They used standard textile testing methods on both used and unused patient gowns.
“Some of the tests I performed included thermal resistance using a heated manikin and air permeability,” says O’Brien, who sees the cross-functional experience as being attractive to future employers. “I then provided suggestions for new material development and new gown design that would improve thermal performance.”
Why not develop a gown that can keep patients insulated throughout the process? –Dr. Adam Thaler
Yorko and Patania are currently working on the team as part of their senior design project, focusing on studying the different properties of existing patient gowns in regards to heat transfer and thermodynamics. They will use that information to help create a new product, says Yorko, who sees this as a great opportunity for cross-disciplinary studies.
“I’ve always been interested in the medical field, and how engineering can affect medical issues,” Yorko says. “When I had a chance to pick a senior design project, this had that tie-in to medicine so it was a natural fit.”
When he arrived at Jefferson two years ago, Dr. Thaler learned of the great relationship that the medical college has with the textiles and engineering programs. The “gorilla gown” idea which had been percolating in his mind got the boost he needed.
While the Bair Hugger and other items helped offset hypothermia concerns, he sought a cost-effective way to improve the “aesthetically unpleasing gowns which had been used forever.”
“The current gowns don’t do anything to keep patients warm. The environment is cold before going into the operating room, and cold once in the operating room,” he says, noting that body heat travels from a patient’s core to periphery quickly after going under anesthesia, thus inviting health risks. “We use the Bair Hugger to catch up. Why not develop a gown that can keep patients insulated throughout the process? I thought that we could find a fabric at a reasonable cost which does the job of maintaining heat.”
The team is currently putting the finishing touches on a grant proposal to fund the ‘gorilla gown’ initiative.
Adds Masoodi, “In a typical surgery, when a patient goes from the OR to the postanesthesia care unit, roughly 10 blankets are used to keep patients warm. If we can get that down to one or two, that’s part of what we’re after.”
Initial meetings started a year-and-a-half ago, leading to the ongoing process of redesigning gowns.
Dr. Thaler hopes that, with grant-funding support, work will continue next semester with students who have the goal of designing that new textile material. Still, more research is needed and they hope to bring a PhD student into the mix moving forward.
For now, the team is putting the finishing touches on their NIH grant proposal with the hope of making the “gorilla gown” a regular part of the surgical world.