Why Is Operating Theatre Linen Green or Blue?

Operating theatre gowns and drapes are usually green or blue because those colours are easier on the eyes than white under bright theatre lights, and because they contrast with the reds of blood and tissue. The explanation most often given is that green and blue reduce glare and help the visual "afterimages" that follow staring at red to blend in. There are also practical reasons, including how stains look after laundering.

Below, we look at what is known about the colour choice, what is folklore, and what it means when you choose colours for reusable theatre textiles today.

A short history: from white to green and blue

For much of the early history of modern surgery, theatre clothing and linen were white, which signalled cleanliness. Over the twentieth century, hospitals moved towards green and later blue for gowns, drapes and scrubs.

Popular histories often tell the story of a single influential surgeon switching to green in the early 1900s because it was easier on his eyes. That story is widely repeated, but the accounts we found are second-hand, so we do not rely on it here. What is better documented is the broad direction of travel. Scienceline, a science journalism site, reports that green surgical linens were adopted from around the 1950s and that many hospitals moved to blue during the 1970s. The Wikipedia article on scrubs notes that blue and dark green colours are used in part to minimise afterimages.

The exact dates matter less than the reasons, which still shape how theatre textiles are chosen.

The reasons usually given

Glare under theatre lights

Operating lights are intense and focused on a small field. White fabric around that field reflects a great deal of light back towards the surgical team. Mid and dark shades of green and blue reflect less, which many clinicians find more comfortable during long procedures.

Afterimages

If you stare at a strongly coloured area for a while and then look at a neutral surface, you may see a faint image in the complementary colour. Red's complementary colour is green-cyan. After focusing on red tissue, a surgeon glancing at a white drape or gown might see greenish shapes. On a green or blue surface, those afterimages blend into the background instead of standing out. Scienceline quotes a vision researcher making this point.

Contrast with the surgical field

Green and blue sit opposite red on the colour wheel, so they help the surgical site stand out from the surrounding drapes. Some clinicians feel this helps visual focus, although this is more a matter of practice and preference than of firm evidence.

Stains after laundering

Blood stains on reusable textiles do not always wash out completely. On white fabric, any residual mark is very visible. On green or blue fabric, the mark is much less noticeable. Scienceline mentions this laundering point as one reason green linen was adopted. For reusable textiles that will go through many cycles, this has a real effect on how long items look acceptable.

How strong is the evidence?

Most of the explanations above are practical observations and reasonable inferences from how vision works, rather than conclusions from large modern studies. Many articles online repeat them without primary sources, and some are written by retailers. It is fair to say that green and blue are a well-established theatre convention with sensible reasons behind them, but it is not accurate to claim that a particular shade has been proven to improve surgical outcomes.

If your team wants to depart from the convention, or choose between shades, the best guide is the experience of the people who work under the lights, tested through a wear trial.

Green or blue: practical differences

There is no single right answer. Hospitals use both, and some use both for different purposes.

Consideration	Theatre green	Blue shades
Convention	Long associated with theatre linen and drapes	Widely used for gowns, drapes and scrubs
Glare	Mid and darker shades reduce reflection	Mid and darker shades reduce reflection
Stain visibility after laundering	Residual marks less visible than on white	Residual marks less visible than on white
Telling items apart	Can distinguish drapes from blue gowns, or vice versa	Can distinguish gowns from green drapes, or vice versa
Shade matching across batches	Needs a reference shade on record	Needs a reference shade on record

Many facilities pick colours for reasons that have little to do with optics: matching existing stock, separating theatre textiles from ward linen, or telling scrubs from gowns at a glance.

Choosing colours for reusable theatre textiles today

When you specify reusable OT gowns, drapes, covers and wraps, colour decisions are usually about consistency and identification as much as about the theatre lights.

Keep theatre textiles distinct

Theatre linen should be easy to separate from ward linen in the laundry, in storage and on trolleys. A dedicated theatre colour helps. If wards use white sheets, a theatre green or blue makes misplacement obvious.

Decide whether to colour-code

Some facilities use one colour for all theatre textiles. Others use different colours for gowns and drapes, for different theatres, or for particular item types. Colour-coding can help, but too many colours complicate stock management and par levels. Our post on colour coding OT linen looks at the options.

Think about scrubs as well

Theatre staff usually wear scrubs under gowns. If scrubs are the same shade as gowns, it can be harder to see at a glance who is gowned. Some teams prefer a contrast. The relationship between the two garments is covered in surgical gown vs scrubs, and scrub choices for theatre in operating theatre scrubs.

Specify the shade, not just the colour name

"Green" can mean many things. To keep reorders consistent:

1. Approve a physical sample or fabric swatch as the reference shade.
2. Record the approved shade with the specification, along with the fabric type.
3. Check new batches against the reference before they go into use.
4. Expect some fading over time with repeated laundering, and plan replacements so that old and new items are not mixed in a way that matters to your team.

Consider colour fastness

Reusable theatre textiles go through hot washing and, for many items, sterilisation. Ask the supplier about colour fastness for your laundering process, and include it in your sample trial. A shade that fades unevenly will look worn quickly and may make colour-coding less reliable.

A short checklist

• Agree whether theatre textiles share one colour or are coded
• Keep theatre colours distinct from ward linen
• Decide whether gowns should match or contrast with scrubs
• Approve and record a reference shade
• Trial colour fastness through your own laundry and reprocessing cycle
• Check each reorder against the reference

Colours available for reusable OT textiles

MISHAREN makes reusable surgeon gowns, drapes, trolley and Mayo stand covers and instrument wrapping cloths in theatre green, blue and other colours, in cotton or poly-cotton woven fabrics, at its production unit in Konni, Kerala, and ships each order to the UAE.

To compare shades on a sample or request a quotation, see our OT gowns and drapes range or get in touch through the contact page.