What do drapes do?
Provide a fluid/blood resistant barrier to minimize passage of microorganisms from unsterile areas
Reduce risk of health care associated infections
Cover patient
Cover equipment/furniture adjacent to sterile field
6 key principles of draping?
Ensure drape is unfolded correctly
-follow manufactures directions
Place drapes over the intended surgical incision site or by it and drape out peripherally
Handle drapes as little as possible
Cuff your hand in a fold of drape to prevent hand contamination
Only top surface of drape is sterile
Once placed do not move top surface of drape
What is key principle of surgical draping?
Cuffing
Types of sterile drapes?
Sterile towels Incise Drapes Laparotomy drapes Upper extremity drapes Lower extremity drapes Lithotomy drapes Split sheet
Sterile towel drapes?
Sterile impervious towel drapes only towel classified as a drape
Sterile cloth towels do not provide a barrier for the passage of microorganisms from unsterile to sterile areas
What are sterile towels used for?
Squaring off incision site
Wrap head
Wrap around extremity
How are towels secured?
Non penetrating towel clamps
Skin staples
Incise drapes?
Large plastic adhesive drape that may be applied to incisional area
- antimicrobial properties
Laparotomy drapes?
For abdominal, chest and thoracic procedures
- towel placed to outline incision site followed by laparotomy drapes
Unfolding laparotomy drapes?
Square incision site with towels
Place fenestration (hole) of abd drape at proposed site of incision
2 sterile members unfold the drape to the foot of then bed and then unfold to head of bed
Upper extremity drapes?
Used for upper limb extremity Hand Wrist Elbow Forearm
What should drape cover?
Max surface area
Lower extremity drapes?
Used for lower limb surgery
Foot
Ankle
Leg
Lithotomy drapes?
Leggings are drapes used to cover lower extremities and stirrups when pt is in lithotomy
Why might an additional drape me placed under the buttocks when patient in lithotomy position?
To drape perineal area to prevent blood/body fluid from soaking into the linen
- protect skin
- decrease contact with OR bed
Split sheet drape?
Sheets cut linear to allow drapes to be wrapped around the area
Commonly used for ENT, head + neck and ortho procedures
Very versatile
Mayo stand draping
Foot to stabilize stand
Dominant hand cuffed within fold of the cover while the opposite hand feeds the drape down the vertical stand
Where is the mayo stand considered sterile?
On top of the tray and underneath the tray because it is placed over the sterile field
How to decrease risk of contamination during draping?
Careful attention when draping
Monitored closely by surgical team
After draping discard gloves and don new pair
Sterile members avoid reaching over unsterile areas
If blood/body fluid penetrates through drape/gown it is contaminated
How to drape equipment?
Follow manufacturers instructions.
Ex. C arms
Drape as close to time of use as possible
Equipment that does not need to be draped?
Lights
Anesthesia cart/machine
ESU
Stools
Placing drapes for CVC/PICC?
Don mask & eye protection
Skip prep
Sterile gown & gloves
Drape patient with full body drape
Removing drapes?
Done by scrubbed team members
Carefully pull drape towards the foot of the bed after incision is protected
Goal of drapes?
Create barrier to minimize microscopic organisms passage from the unsterile areas to sterile fields
Variety of sterile towels?
Impervious towel drapes
Disposable cloth towels
Reusable cloth towels
- cloth towels are not drapes
*impervious towels are only towel considered a drape