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Scrubs are the sanitary
clothing Clothing (also known as clothes, apparel, and attire) are items worn on the human body, body. Typically, clothing is made of fabrics or textiles, but over time it has included garments made from animal skin and other thin sheets of materials ...
worn by
physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
,
nurses Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ca ...
,
dentists A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry (the diagnosis, prevention, management, and treatment of diseases and conditions of the oral cavity and other aspects of the craniofacial com ...
and other workers involved in patient care. Originally designed for use by surgeons and other
operating room Operation or Operations may refer to: Arts, entertainment and media * ''Operation'' (game), a battery-operated board game that challenges dexterity * Operation (music), a term used in musical set theory * ''Operations'' (magazine), Multi-Ma ...
personnel, who would put them on when sterilizing themselves, or "scrubbing in", before surgery, they are now worn by many hospital personnel. Their use has been extended outside hospitals as well, to work environments where clothing may come into contact with infectious agents (
veterinarian A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, vet ...
s, midwives, etc.). Scrubs are designed to be simple (with minimal places for
contaminants Contamination is the presence of a constituent, impurity, or some other undesirable element that spoils, corrupts, infects, makes unfit, or makes inferior a material, physical body, natural environment, workplace, etc. Types of contamination W ...
to hide), easy to launder, and cheap to replace if damaged or stained irreparably. In the United Kingdom, scrubs are sometimes known as theatre blues. The spread of methicillin-resistant ''Staphylococcus aureus'' (MRSA) has increased the use of scrubs but can give wearers a false sense of security that they are 'clean' when in fact they are as easily contaminated as any other clothing.


History of surgical attire

In contrast to the uniforms long required of
nurse Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
s, surgeons did not wear any kind of specialized garments until well into the 20th century.
Surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...
procedures were conducted in an operating theater. The surgeon wore their own clothes, with perhaps a butcher's apron to protect their clothing from blood stains, and they operated bare-handed with non- sterile instruments and supplies. (Gut and silk sutures were sold as open strands with reusable hand-threaded needles; packing
gauze Gauze is a thin, translucent fabric with a loose open weave. In technical terms "gauze" is a weave structure in which the weft yarns are arranged in pairs and are crossed before and after each warp yarn keeping the weft firmly in place ...
was made of sweepings from the floors of cotton mills.) In contrast to today's concept of surgery as a profession that emphasizes cleanliness and conscientiousness, up to the early 20th century the mark of a busy and successful surgeon was the profusion of blood and fluids on their clothes. The importance of dress as a badge of one's class in society was paramount and the processes behind the transmission of infection were the subject of controversy within the profession. With the "
Spanish flu The 1918–1920 influenza pandemic, commonly known by the misnomer Spanish flu or as the Great Influenza epidemic, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. The earliest documented case wa ...
"
pandemic A pandemic () is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. A widespread endemic disease with a stable number of i ...
of 1918 and the growing medical interest in Lister's
antiseptic An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
theory, some surgeons began wearing cotton gauze masks in surgery; however, this was not to protect the patient from intra-operative
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...
, but to protect the surgeon from the patient's diseases. Around the same time, operating theatre staff began wearing heavy rubber gloves to protect their hands from the solutions used to clean the room and equipment, a practice surgeons grudgingly adopted. By the 1940s, advances in surgical antisepsis (now called aseptic technique) and the science of wound infection led to the adoption of antiseptic drapes and gowns for
operating room Operation or Operations may refer to: Arts, entertainment and media * ''Operation'' (game), a battery-operated board game that challenges dexterity * Operation (music), a term used in musical set theory * ''Operations'' (magazine), Multi-Ma ...
use. Instruments, supplies and dressings were routinely sterilized by exposure to either high-pressure steam or
ethylene oxide Ethylene oxide is an organic compound with the formula . It is a cyclic ether and the simplest epoxide: a three-membered ring consisting of one oxygen atom and two carbon atoms. Ethylene oxide is a colorless and flammable gas with a faintly sw ...
. Originally, operating room attire was white to emphasize cleanliness. However, the combination of bright operating lights and an all-white environment led to eye strain for the surgeon and staff. By the 1950s and 1960s, most hospitals had abandoned white operating room apparel in favor of various shades of green, which provided a high-contrast environment, reduced eye fatigue, and made bright red blood splashes less conspicuous. By the 1970s, surgical attire had largely reached its modern state—a short-sleeve V-necked shirt and drawstring pants or a short-sleeve calf-length dress, made of a cotton or cotton/ polyester blend. Over this was worn a tie-back or bouffant-style cloth cap, a gauze or synthetic textile mask, a cloth or synthetic surgical gown,
latex gloves Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well. In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiospe ...
, and supportive closed-toe shoes. This uniform was originally known as "surgical greens" because of its color, but came to be called "scrubs" because it was worn in a "scrubbed" environment.


Use

In many operating rooms, it is forbidden to wear any exposed clothing, such as a
t-shirt A T-shirt (also spelled tee shirt), or tee, is a style of fabric shirt named after the T shape of its body and sleeves. Traditionally, it has short sleeves and a round neckline, known as a '' crew neck'', which lacks a collar. T-shirts are genera ...
, beneath scrubs. As scrubs are designed to promote a clean environment, the wearing of outside clothing is thought to introduce unwanted pathogens. Nearly all patient care personnel at hospitals in the United States wear some form of scrubs while on duty, as do some staffers in doctor, dental, and veterinary offices. Doctors in the United States may wear their own clothes with a
white coat A white coat, also known as a laboratory coat or lab coat, is a knee-length overcoat or smock worn by professionals in the medical field or by those involved in laboratory work. The coat protects their street clothes and also serves as a simpl ...
except for surgery. Support staff such as custodians and unit clerks also wear scrubs in some facilities. When the physician is not performing surgery, the scrub is often worn under a white coat. In England, all NHS hospital trusts have stringent clothing policies, and many of these specifically forbid wearing the iconic white coat for medical staff, owing to infection control concerns. This has meant that several hospitals around the UK have opted for scrubs for staff, especially in Accident and Emergency departments. Scrubs are also sometimes used as prison uniforms in the U.S and other countries. Outside of hospitals, scrubs are becoming more common in other areas especially in light of the global COVID-19 pandemic. Non-traditional industries using scrubs include workout facilities, schools, and restaurants. Health and safety standards are critical to restaurants’ success and legal compliance, and there are many opportunities for bacteria to thrive and spread via menus, tables, and shared condiment shakers.


Modern scrubs

Today, any medical
uniform A uniform is a variety of clothing worn by members of an organization while participating in that organization's activity. Modern uniforms are most often worn by armed forces and paramilitary organizations such as police, emergency services, se ...
consisting of a short-sleeve shirt and pants is known as "scrubs". Scrubs may also include a waist-length long-sleeved jacket with no lapels and stockinette cuffs, known as a "warm-up jacket".


Colors and patterns

Scrubs worn in surgery are almost always colored solid light grey, light green, light blue or a light green-blue shade. Non-surgical scrubs come in a wider variety of colors and patterns, ranging from official issue garments to custom made, whether by commercial uniform companies or by home-sewing using commercially available printed
patterns A pattern is a regularity in the world, in human-made design, or in abstract ideas. As such, the elements of a pattern repeat in a predictable manner. A geometric pattern is a kind of pattern formed of geometric shapes and typically repeated li ...
. Some hospitals use scrub color to differentiate between patient care departments (i.e., Surgery,
Childbirth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births glo ...
, Emergency, etc.) or between licensed patient care personnel (nurses, radiologic technologists, respiratory and physical therapists, etc.), unlicensed assistive personnel, and non-patient care support staff (i.e., portering, dietary, unit clerks, etc.). Hospitals may also extend the practice to differentiate non-staff members/visitors. In England and Wales many NHS trusts use different colored scrubs to distinguish between different branches of healthcare professionals, for example anaesthetists may wear maroon. This allows staff and patients to easily spot the workers they are looking for in a high-pressure situation. Piping of different colors or pattern are also often used to distinguish seniority. Many hospitals have posters in reception areas explaining this system but it is mainly designed for hospital staff. Custom-made printed scrub tops, featuring cartoon characters and cheerful prints, are common in
pediatrician Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until th ...
s' offices,
veterinary Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
offices, dental clinics and children's hospitals, and prints for various holidays can be seen throughout the year. Some acute care facilities or larger hospitals also have relaxed rules regarding the wear of non-regulation scrubs in non-surgical units, and they are no longer just the classic v-neck scrub tops, but are now offered in many styles and patterns. The scrub industry, much like maternity wear, used to have very limited fashion options. Indeed, scrubs were generally box shaped and ill fitted, often with limited design choices. Over the past 10 years the scrub industry has taken notice of the individual preferences of medical professionals and have begun to design and manufacture fashionable and unique designs.


Cleaning

Surgical scrubs are not generally owned by the wearer. Due to concerns about home laundering and sterility issues, these scrubs are usually hospital-owned or hospital-leased through a commercial linen service. And due to these laundering and sterility limitations, disposable scrub suits were introduced in the market.


Accessories


Scrub caps

Scrub caps have graduated from being functional to also being a personalized accessory both in the operating room and outside. Before the antiseptic focus of the 1940s, hats were not considered essential to surgery. From the 1940s through the 1950s, as a hygienic focus swept the industry, hats became standard wear to help protect patients from contaminants in hair. Full-face hats were even designed for men with beards. These hats have been and continue to be distributed by group purchasing organizations (GPOs) who supply hospitals with most equipment. In the medical fashion 'revolution' of the seventies, more and more medical professionals began personalizing their scrubs by either sewing their own hats or buying premade hats made of colorful patterned fabric. Several styles were popular, including the 'bouffant' surgical cap, a utilitarian hairnet-like hat which typically comes in light blue, and the 'milkmaid', a bonnet-like wrap around hat. Bouffant surgical caps are perhaps the most widely used scrub hats in hospitals, and their usage is not limited to only nurses and surgeons: hospital patients are required to wear a bouffant cap when having surgery of any kind. In 2016, a controversy emerged in the US around the use of cloth or disposable surgical caps vs mandatory use of bouffant style surgical caps. This controversy ended in state mandates for the use of bouffant caps to comply with
Joint Commission The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world. A majori ...
standards.


Sterile hijab

Some Muslim women prefer to keep wearing their hijab while working in the operating theatre. Hospitals in the UK and the US began providing disposable hijabs as an alternative to surgical caps.


See also

*
White coat A white coat, also known as a laboratory coat or lab coat, is a knee-length overcoat or smock worn by professionals in the medical field or by those involved in laboratory work. The coat protects their street clothes and also serves as a simpl ...


References


External links


Scrubs then and now

Frock coats to scrubs: a story of surgical attire
{{DEFAULTSORT:Scrubs (Clothing) History of fashion Medical equipment Uniforms Medical hygiene Suits (clothing)