Table 1.

Classification of barrier performance of surgical gowns, other protective apparel, surgical drapes, and drape accessories according to ANSI/AAMI PB70:2012 with examples of procedures from AAMI TIR11:2005

Levela	Test	Liquid challenge	Result	Expected barrier effectiveness	Examples of procedures with anticipated exposure risksb
1	AATCC 42: impact penetrationc	Water	≤4.5 g	Minimal water resistance (some resistance to water spray)	Simple excisional biopsies Excision of ‘lumps and bumps’ Ophthalmologic procedures Simple ear, nose, and throat procedures
2	AATCC 42: impact penetration	Water	≤1.0 g	Low water resistance (resistant to water spray and some resistance to water penetration under constant contact with increasing pressure)	Tonsillectomies and adenoidectomies Endoscopic gastrointestinal procedures Simple orthopedic procedures with tourniquets
	AATCC 127: hydrostatic pressured	Water	≥20 cm		Open hernia repair Minimally invasive surgery Interventional radiology or catheter lab  procedures
3	AATCC 42: impact penetration	Water	≤1.0 g	Moderate water resistance (resistant to water spray and some resistance to water penetration under constant contact with increasing pressure)	Mastectomies Arthroscopic orthopedic procedures Endoscopic urological procedures (for example, transurethral prostate resections)
	AATCC 127: hydrostatic pressure	Water	≥50 cm		Open gastrointestinal and genitourinary  procedures
4	ASTM F1670: synthetic blood penetration test (for surgical drapes)e	Surrogate blood	no penetration at 2 psi (13.8 kPa)	Blood and viral penetration resistance (2 psi)	Any procedure in which the surgeon's  hands and arms are in a body cavity Orthopedic procedures without a tourniquet Open cardiovascular or thoracic procedures
	ASTM F1671: viral penetration test (for surgical and isolation gowns)f	ΦX174	no penetration at 2 psi (13.8 kPa)		Caesarean sections Trauma procedures

Adapted with permission from AAMI.²

^aIn order of increasing protection.

^bExamples are only general suggestions and should not be interpreted as absolutes or policy statements.

^cAmerican Association of Textile Chemists and Colorists (AATCC) 42 determines the ability of a material to resist water penetration under spray impact.

^dAATCC 127 determines the ability of a material to resist water penetration under constant contact with increasing pressure.

^eAmerican Society for Testing and Materials (ASTM) F1670, similar to ISO 16603, determines the ability of a material to resist the penetration of synthetic blood under constant contact.

^fASTM F1671, similar to ISO 16604, determines the ability of a material to resist the penetration of a microorganism under constant contact. This is standard test for the barrier layer material and barrier layer seams used in the construction of garments, work gloves, face protection devices, footwear, and footwear covers (NFPA 1999).