If you haven't been in the market for new drapes for a while, you might want to take a look: Specialized, procedure-specific and equipment-specific drapes might eliminate excessive draping, and offer you easier application and better barrier protection. Here's a rundown of some of your newest options.
"Drapes prevent the migration of the patient's own flora by sealing the wound edges and prepared skin surface," says Laurie Lander, RN, a market manager at Microtek Medical. "If we take that a step further and impregnate the incise material with an effective antimicrobial agent, common sense would imply that the migration of resident flora would be even further slowed or prevented, particularly during long procedures."
Antimicrobial drapes can cost up to 30 percent more than a comparable drape without antimicrobial properties. "We only use antimicrobial drapes for long orthopedic cases like shoulders, and even then it is at the request of the surgeon," says Marilyn Ropplo, RN, the director of nurses at Surgery Center of Mesquite in Mesquite, Texas.
Here's the latest in antimicrobial drapes.
- Ioban 2 antimicrobial incise drape from 3M provides a sterile surface and acts as a barrier to prevent skin flora from migrating to the incision site. Available in several sizes, Ioban 2 provides continuous broad-spectrum antimicrobial activity throughout the procedure to help reduce the risk of surgical-site contamination. 3M says the drape's so-called low-memory film stretches and conforms to body contours.
- Microtek Medical offers the impervious Vertical Isolation with antimicrobial incise film and fluid-collection pouch, made with Microban, a patented process that encases the antibacterial agent triclosan in the drape. The drape is transparent, providing a clear view of surgical markings, and contains no iodine or latex. The fluid pouch also contains a screen to prevent fishing for sponges and instruments. The drape also offers ample material (it's 130 inches by 96 inches) for covering the patient and equipment, the company says.
Good fluid control means better infection control and better visualization of the surgical site, says Diana Procuniar, RN, BA, CNOR, the director of the Winter Haven ASC in Winter Haven, Fla.
- You might be able to protect your GI surgeons and staff from body fluids and maintain a cleaner environment during colonoscopy procedures with the Coloshield Colonoscopy Drape from Medical Concepts Development. The Coloshield's two-piece system comprises an opaque adhesive drape and a locking ring, which connects to a disc with a self-sealing valve and a reservoir for extra lubrication. The opaque adhesive drape is placed over the patient. The scope is then inserted through the lubrication disc, which locks into place. As the scope is inserted and withdrawn, it is constantly lubricated by the K-Y jelly that fills the disc, and bodily fluids are collected in a pouch.
- Microtek Medical's Perfect Pouch inflatable rim remains upright and functional even during long procedures, says the company. The PerfectPouch inflation pump is attached to the drape, near the valve. To inflate the rim, detach the pump by breaking the paper tab. Insert the pump into the valve to open it completely. Pump until it's inflated, then close the valve.
"Shopping for microscope drapes is like shopping for vacuum cleaner bags," says Ms. Procuniar. "You have to find one that fits." In addition, consider optical quality and glare.
- Carl Zeiss' OPMI Drapes with VisionGuard may offer better optical performance. The VisionGuard is not a lens cover but a disposable plastic lens. "Surgeons in the past have commented that the optical quality of the lens cover does not match that of the microscope," says Elizabeth Garcia, a marketing manager at Carl Zeiss Surgical. "With VisionGuard, surgeons get the benefits of draping without sacrificing the optical quality." As wiping the lens could scratch it, individual lenses are also sold separately so you can replace the lens without having to re-drape the scope.
- The Universal adaptor from Contour Fabricators lets you use the same drape on 54mm, 65mm and 68mm microscope lenses. The company says this reduces the risk of pulling the wrong size drape for a case.
- You may be able to minimize glare with Contour Fabricators' Tilt and Rotate Drape. Its extra adaptor lets the surgeon tilt and adjust only the lens portion. "If you look at existing drapes, the lenses are fixed into place. With the Tilt and Rotate Drape, surgeons can tilt the lens to deflect the glare," says Mike Czop, a product manager at Contour Fabricators. This drape fits all standard microscope makes.
- If you do retina with a Moellor Eibos (Erect Indirect Binocular Ophthalmic System) on your microscope, Contour Fabricators has a drape with a flexible plastic housing that fits the shape of the Eibos. Multiple lenses are inserted into the housing, which is then attached to a polyethylene drape for a custom-fit drape.
Wet cases, such as orthopedic procedures mean wet drapes - which are more vulnerable to strike-through, meaning microorganisms or fluids break through the barrier material. "We just changed some of our draping material because we were getting strike-through. We were using towels under the drapes for added security," says Ms. Ropplo. "Purchasing drapes made from a stronger material was worth the additional cost to not use extra towels."
Some new orthopedic drapes:
- The Rapid-Ex drape from Cardinal Health combines the patient drape, arm board cover and stockinet in one system, which might make draping for upper-extremity cases more efficient. "The idea came from an orthopedic surgeon in California who was using three or four different drapes to set up for hand surgery," says Brodie Bauders, the product manager for the Rapid-Ex drape. It is made with Tiburon surgical drape fabric that combines three fabric layers: an absorbent fluid-control layer, an impermeable membrane and a patient comfort layer." The top layer holds and disperses fluid, keeping it from pooling on top of the patient, says the company.
- Molnlycke Health Care offers two new shoulder drapes especially for arthroscopic procedures and a total-hip drape. All three feature Velcro-like tab and cord holders to keep the sterile field organized and to form large fluid-collection pouches.
- Kimberly-Clark offers two new orthopedic drapes: the beach chair shoulder drape and hip drape. The shoulder drape features a one-piece design with attached fluid-collection pouch. The hip drape features large, clear leg pockets on both sides, so the drape can be used on either the left or right hip. Both drapes are made of an excellent barrier fabric to reduce blood strikethrough, says the company. The drapes scored a maximum rating for flame resistance for safe use around laser and other electrical instruments, says the company. Both drapes come in a choice of fabric reinforcements designed either to reduce instrument slippage or fluid run-off.
Andrea Hyatt, CASC, the administrator at the Dulaney Eye Institute in Towson, Md., looks for ophthalmic drapes with and without apertures, pre-cut drapes and those with easily removed adhesive. Here's what new:
- Alcon's Akahoshi Drape is for cataract procedures with a smaller fenestration area and pre-slit incise for easy placement of the lid speculum and fast removal after surgery, says the company. The drape is made of Alcon's purple, non-woven fabric and is 48 inches by 60 inches.
- Eyeshield's Duotape is specialized for ophthalmic surgery. The film is die-cut to the shape of the eye: a deep curve for the upper lid and a shallow curve for the lower lid. The tabs on the ends are perforated so they can be cleared out of the way of instruments, says the company. Tack the ends into the fluid-retention bag to create the Duoflo system for cataract surgery.
Here are new children's drapes.
- Designed by pediatric ophthalmologists for strabismus or other bilateral eye surgery, Alcon's new pediatric drape has an aperture opening with a smaller adhesive area for easier removal and increased patient comfort. This drape is made of Alcon's purple non-woven fabric, which offers improved softness, strength and better fluid repellency, the company says.
- Molnlycke Health Care has developed several drapes for pediatric abdominal and thoracic procedures. Their fenestrations are designed to fit children and adolescents while providing ample drape coverage, says the company. The drape is reinforced around the incision site to absorb fluids and provide an impervious barrier to fluids and viruses. New velcro-like tabs help keep the sterile field organized and, according to the company, are especially useful for minimally invasive procedures.
Facilities that do a lot of small, quick procedures may be able to standardize with Viscot Industries' 1636-4A drape, which can be used for many minor procedures, the company says. The moisture-repellant drape is 24 inches by 36 inches with a 4-inch fenestration surrounded by an adhesive patch. It's also available with adhesive strips on the edge to prevent slippage. Because it's autoclavable, surgery centers sterilize the drapes as needed.