Scrubs (clothing)
Encyclopedia
Scrubs are the shirts and trousers or gowns worn by nurses (perioperative nurse), surgeon
s, and other operating room personnel when "scrubbing in" for surgery
. In the United Kingdom, they are sometimes known as Theatre Blues. They are designed to be simple with minimal places for dirt to hide, easy to launder, and cheap to replace if damaged or stained irreparably. The wearing of scrubs has been extended outside of surgery in many hospital
s. Originally issued as replacement clothing if street clothing was contaminated, scrubs are now worn by any hospital personnel in any clean environment. 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 are as easily contaminated as any other clothing. They have also been mandated in some American prisons as a prison uniform
. The television show Scrubs
is named for this garment.
s did not wear any kind of specialized garments until well into the 20th century. Surgical
procedures were conducted in an operating theater. The surgeon wore his own clothes, with perhaps a butcher's apron to protect his clothing from blood stains, and he 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 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 his clothes. The importance of dress as a badge of one's class in society was important and the processes behind the transmission of infection were the subject of controversy within the profession.
With the "Spanish flu
" pandemic
of 1918 and the growing medical interest in Lister
's antiseptic theory, some surgeons began wearing cotton gauze masks in surgery; however, this was not to protect the patient from intra-operative infection
, 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 use. Instruments, supplies and dressings were routinely sterilized by exposure to either high-pressure steam
or ethylene oxide
gas.
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 green 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, 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.
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". 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
except for surgery. Support staff such as custodians and unit clerks also wear scrubs in some facilities.
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
.
Some hospitals use scrub color to differentiate between patient care departments (i.e. Surgery, Labor and Delivery, Emergency, etc.) or between licensed patient care personnel (nurses, radiological technicians, 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.
Scrubs featuring cartoon characters and cheerful prints are common in pediatricians' offices and children's hospitals, while 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.
Some scrubs are found in custom colors, e.g. a university hospital may have scrubs in the school's colors.
As an item of casual dress, scrubs have gained acceptance outside of hospitals, for example, as pajamas, workout clothing, or loungewear. They are sometimes used by backpackers in an effort to reduce weight load. Large stencils with the hospital's name or logo imprinted on them (commonly on pockets or at knees) are designed to prevent theft due to their increased popularity as casual wear.
s (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 eclectic fabric
. Several styles were popular, including the 'bouffant', a utilitarian hairnet-like hat, and the 'milkmaid', a bonnet-like wrap around hat.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
s, and other operating room personnel when "scrubbing in" for surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
. In the United Kingdom, they are sometimes known as Theatre Blues. They are designed to be simple with minimal places for dirt to hide, easy to launder, and cheap to replace if damaged or stained irreparably. The wearing of scrubs has been extended outside of surgery in many hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s. Originally issued as replacement clothing if street clothing was contaminated, scrubs are now worn by any hospital personnel in any clean environment. The spread of Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus is a bacterium responsible for several difficult-to-treat infections in humans. It is also called multidrug-resistant Staphylococcus aureus and oxacillin-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 are as easily contaminated as any other clothing. They have also been mandated in some American prisons as a prison uniform
Prison uniform
A prison uniform is any uniform worn by individuals incarcerated in a prison, jail or similar facility of detention.-Nazi Germany:During the Nazi period of Germany, interned people in the concentration camp system were often made to wear prisoner's uniforms.-Convict era:In the United Kingdom,...
. The television show Scrubs
Scrubs (TV series)
Scrubs is an American medical comedy-drama television series created in 2001 by Bill Lawrence and produced by ABC Studios. The show follows the lives of several employees of the fictional Sacred Heart, a teaching hospital. It features fast-paced screenplay, slapstick, and surreal vignettes...
is named for this garment.
History of surgical attire
In contrast to the uniforms long required of nurses, surgeonSurgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
s did not wear any kind of specialized garments until well into the 20th century. Surgical
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
procedures were conducted in an operating theater. The surgeon wore his own clothes, with perhaps a butcher's apron to protect his clothing from blood stains, and he operated bare-handed with non-sterile
Sterilization (microbiology)
Sterilization is a term referring to any process that eliminates or kills all forms of microbial life, including transmissible agents present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media...
instruments and supplies. (Gut and silk sutures were sold as open strands with reusable, hand-threaded needles; packing gauze 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 his clothes. The importance of dress as a badge of one's class in society was important and the processes behind the transmission of infection were the subject of controversy within the profession.
With the "Spanish flu
Spanish flu
The 1918 flu pandemic was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus . It was an unusually severe and deadly pandemic that spread across the world. Historical and epidemiological data are inadequate to identify the geographic origin...
" pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...
of 1918 and the growing medical interest in Lister
Joseph Lister, 1st Baron Lister
Joseph Lister, 1st Baron Lister OM, FRS, PC , known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery, who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary...
's antiseptic theory, some surgeons began wearing cotton gauze masks in surgery; however, this was not to protect the patient from intra-operative infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
, 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 use. Instruments, supplies and dressings were routinely sterilized by exposure to either high-pressure steam
Autoclave
An autoclave is an instrument used to sterilize equipment and supplies by subjecting them to high pressure saturated steam at 121 °C for around 15–20 minutes depending on the size of the load and the contents. It was invented by Charles Chamberland in 1879, although a precursor known as the...
or ethylene oxide
Ethylene oxide
Ethylene oxide, also called oxirane, is the organic compound with the formula . It is a cyclic ether. This means that it is composed of two alkyl groups attached to an oxygen atom in a cyclic shape . This colorless flammable gas with a faintly sweet odor is the simplest epoxide, a three-membered...
gas.
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 green 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, 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.
Modern scrubs
Today, any medical uniformUniform
A uniform is a set of standard clothing worn by members of an organization while participating in that organization's activity. Modern uniforms are worn by armed forces and paramilitary organizations such as police, emergency services, security guards, in some workplaces and schools and by inmates...
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". 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
White coat
A white coat or laboratory coat is a knee-length overcoat/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 simple uniform...
except for surgery. Support staff such as custodians and unit clerks also wear scrubs in some facilities.
Colors and patterns
Scrubs worn in surgery are almost always colored solid light green, light blue or a light green-blue shade, although some medical centers have switched to pink as a theft deterrent. Surgical scrubs are not owned by the wearer; due to concerns about home laundering and sterility issues, these scrubs are hospital-owned or hospital-leased through a commercial linen service.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
Pattern (sewing)
In sewing and fashion design, a pattern is an original garment from which other garments of a similar style are copied, or the paper or cardboard templates from which the parts of a garment are traced onto fabric before cutting out and assembling .Patternmaking, pattern making or pattern cutting is...
.
Some hospitals use scrub color to differentiate between patient care departments (i.e. Surgery, Labor and Delivery, Emergency, etc.) or between licensed patient care personnel (nurses, radiological technicians, 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.
Scrubs featuring cartoon characters and cheerful prints are common in pediatricians' offices and children's hospitals, while 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.
Some scrubs are found in custom colors, e.g. a university hospital may have scrubs in the school's colors.
External wear
Scrubs are not as common in hospitals outside of the United States. In most of Europe, for example, nurses and midwives mostly wear a uniform of tunic and trousers or a dress. Doctors tend to wear their own clothes with a white coat except for surgery, when they wear scrubs. In the UK, all NHS hospital trusts have stringent clothing policies, and many of these specifically forbid the wearing of 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.As an item of casual dress, scrubs have gained acceptance outside of hospitals, for example, as pajamas, workout clothing, or loungewear. They are sometimes used by backpackers in an effort to reduce weight load. Large stencils with the hospital's name or logo imprinted on them (commonly on pockets or at knees) are designed to prevent theft due to their increased popularity as casual wear.
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 organizationGroup purchasing organization
In the United States, a group purchasing organization is an entity that is created to leverage the purchasing power of a group of businesses to obtain discounts from vendors based on the collective buying power of the GPO members....
s (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 eclectic fabric
Textile
A textile or cloth is a flexible woven material consisting of a network of natural or artificial fibres often referred to as thread or yarn. Yarn is produced by spinning raw fibres of wool, flax, cotton, or other material to produce long strands...
. Several styles were popular, including the 'bouffant', a utilitarian hairnet-like hat, and the 'milkmaid', a bonnet-like wrap around hat.