Scrubs (clothing)


 * For other uses see Scrubs (disambiguation).

Scrubs are the shirts and trousers or gowns worn by surgeons, nurses, and other operating room personnel when "scrubbing in" for surgery. The wearing of scrubs has been extended outside of surgery in many hospitals. Scrubs are now worn by any hospital personnel in any clean environment. The spread of Methicillin-resistant Staphylococcus aureus has increased the necessity and usage of scrubs.

History of surgical attire
In contrast to the uniforms long required of nurses, surgeons did not wear any kind of specialized garments until well into the 20th century. Surgical procedures were conducted in an "operating theatre" - an amphitheatre- or auditorium-type room with a raised table at center stage and several rows of seats to allow students and other spectators to observe the case in progress. The surgeon wore his street 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, at the beginning of the 20th century the mark of a busy and successful surgeon was the profusion of blood and fluids on his clothes.

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 ("OR") use. Instruments, supplies and dressings were routinely sterilized by exposure to either high-pressure steam or ethylene oxide (EtO) gas.

Originally, OR attire was white to emphasize cleanliness. However, the combination of bright operating lights and an all-white environment led to eyestrain for the surgeon and staff, and additionally, many people found the sight of bright red blood splashes on a white gown or drape rather off-putting. By the 1950s and 1960s, most hospitals had abandoned white OR apparel in favor of various shades of green, which provided a high-contrast environment and reduced eye fatigue.

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 uniform consisting of a short-sleeve shirt and pants are 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 in the United States wear some form of scrubs while on duty, as do some staffers in doctors' offices. These types of scrubs can come in any color or pattern. 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 hospitals use scrub color as a way of quickly identifying a staff member's department, e.g. light blue for Surgery, pink or lavender for Labor and Delivery, dark green or dark blue for Emergency, and so forth. A few hospitals extend this convention to non-staff and visitors in order to make these people clearly identifiable. (For example, visitors may wear yellow scrubs, while staffers wear blue.) Scrubs may have the hospital's name or logo imprinted on them (commonly on pockets or at knees), or they can come in custom colors, e.g. a university hospital may have scrubs in the school's colors.

Scrubs worn in surgery, in contrast, are almost always colored solid light green, light blue or a light green-blue shade. Surgical scrubs are rarely 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.

Scrubs are not as universal in hospitals outside of the United States, for example in most of Europe Nurses and Midwives mostly wear a uniform of tunic and trousers or a dress. Doctors tend to wear smart clothes with a white coat except for surgery.

Scrub caps
Scrub hats (scrub caps) have graduated from being functional to being a personalizable accessory both in the OR and outside. Before the antiseptic focus of the 40's, hats were not considered essential to surgery. In the forties and fifties, 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 eclectic fabric. Several styles were popular, including the 'bouffant', a utilitarian hairnet-like hat, and the 'milkmaid', a bonnet-like wrap around hat. Another revolution occurred recently fortifying the fashion focus of the medical scrub industry. The blue sky scrubs 'Pony' hat was invented in Texas for fashion conscious medical personnel. The hat holds up long hair and is made in several styles.