The Mölnlycke O.R. blog
Drape Expectations – To drape or not to drape
I’m not really asking whether we should drape our patients prior to surgery, but I do want to make us think about why we do it and with what.
As a theatre nurse, a global training manager and in the past an international product manager, I have been in the privileged position of visiting hospitals, nurses and surgeons all over the world. I’ve been lucky enough to be invited into their operating theatres (or operating rooms if you prefer) to see how they do what they do and to see what it is they need now or in the future. This has been fascinating for me – as an ex senior scrub nurse – not because of the differences but because of the similarities.
Common practices abound. People wear special clothes (ok, they look like pyjamas to the rest of the world!), the surgeons and their scrub teams wear hats, masks, gowns and gloves and the patient is draped – all of this in order to maintain a sterile field in which to operate safely. Everywhere I have been, the war on surgical site infection (SSI) is fought.
Bacteria are able to survive in many environments and can always flourish where conditions are right. They are adaptable, cunning and should always be respected. Inevitably and despite our best efforts they sometimes manage to infect the patient’s surgical wound, although some practitioners claim that they never get SSIs. The global rise in antibiotic-resistant-bacterial strains means that SSI rates will increase, so let’s look at one of the main defences we have against it – drapes that work effectively.
But – before I ask further questions – please think about this. I am often asked to either “prove” that a certain material leads to a lower infection rate or am told that there is not a problem and single-use drapes are not necessary. The question, above all others, that I want you to ask yourself is this – why drape at all? After all, laboratory and in vitro testing can demonstrate the ineffectiveness of certain materials in use, can show that traditional balloon cloth cotton linen is next to useless as a barrier to infection. If that’s your chosen material, why use anything?
Please consider these questions when choosing your drapes. Remember that a surgical drape has one purpose and one purpose only (not the same thing as uses!). That purpose is to keep the bugs out of the wound. Do reusable textile drapes do this?
- How does the reprocessed product perform the 20th, 50th or 70th time?
- How much does this maintenance add to the cost? Pay per incident? Annual charge? Are you being charged for damage caused by another user?
- What’s the cost for your hospital having to complement with single-use products as well?
- Extremity drapes (and others with elasticated apertures)
- Incise film?
- Instrument pouches?
- Product cost?
- System cost? (multiple suppliers)
- The testing process itself (to test for resistance to bacterial penetration) is destructive; how can bacterial-penetration resistance be assured each time that a product is put into use?
Are YOU sure that YOU are not compromising infection control? Is your “sterile conscience” untroubled?