As more surgeries move into the outpatient setting, drapes are getting more procedure-specific as well as equipment-specific. As you'll see in this review, manufacturers are offering a wider variety of specialized drapes than ever before.

Antimicrobial
Incise drapes are nothing new, but now there's another choice from Medical Concepts Development. The ACTI-Gard Antimicrobial Incise Drape is an iodine-based product that comes in five sizes, for procedures such as cardiovascular, neuro, orthopedic or general. A patient isolation drape and a cesarean pouch, both with ACTI-Gard incise, are also available. ACTI-Gard's stable iodine complex remains effective during long procedures (tested up to six hours), according to the company. Its conformable film and aggressive adhesive offer enhanced skin adhesion during long procedures and ones with high fluid volume. This incise drape will cost 30 percent more than a comparable drape without antimicrobial properties, says the company.

3M Incise Drapes have been around for 25 years. Beginning with the clear incise, then offering an antimicrobial incise drape, 3M continues to deliver product enhancements with a poly liner, making application of the drape easier for surgical teams. The 3M Ioban 2 Antimicrobial Incise Drapes are available in four sizes, making them useful for a many surgical procedures. These iodine-based incise drapes provide long-lasting antimicrobial protection at the incision site, says 3M.

ISODrape Surgical Film Drapes from Microtek offer long-lasting antimicrobial protection with Microban (see "What Is Microban?" on page 107), which is permanently built in throughout the drape film. This product is available now but will be formally launched later in 2003. ISODrape is made of an impervious, embossed medical film. The drape's improved transparency offers an unobstructed view of pre-surgical markings, and its adhesive side allows for easy application. The product is latex- and iodine-free.

Orthopedics

Redi-Drape Vertical Isolation Drape, also from Biomet, is a wall drape for hip fractures. It also has a built-in Microban incise drape. This clear poly drape is hung from IV poles, and lets the surgeon view the patient, C-arm image intensifier and TV monitor while remaining in the sterile field, according to the company.

Microtek also offers a Vertical Isolation Drape for hip fractures, with and without viewing windows. These drapes offer Microban antimicrobial protection. The product is latex- and iodine-free.

Microsurgery
Glass Lens Microscope Kover from Advance Medical Designs is a microscope drape with a built-in glass lens. The glass lens offers improved acuity over plastic lenses in competing drapes, which the surgeon may remove. The Glass Lens drape costs 10 to 12 percent more than competing drapes. It may be used with any OR microscope, but the manufacturer says it is most likely to be used during invasive neuro procedures, when sterility is most critical.

Alcon EYE-PAK Ophthalmic Surgical Drapes now come in a purple fabric that offers improved strength and fluid repellency. Its beveled-edge adhesive pattern has 36 percent less adhesive area for greater patient comfort and easier removal. EYE-PAK drapes may be ordered as part of a surgical pack or in sterile, stand-alone packages.

Better fluid control
3M's newest draping material is absorbent and impervious, absorbing spills and splatters that are not collected by a pouch, and making multiple layers unnecessary. 3M Absorbent Impervious Material is made with a soft, low-linting fabric laminated with an impervious film. The material will absorb fluids, preventing them from running off onto the floor, as well as preventing fluid strikethrough. Many competing drapes offer repellency, says 3M, but the unique combination of absorbency and imperviousness provides greater overall safety for patient, staff and surgeon. 3M Absorbent Impervious Material is available in many specialty drapes, including those for arthroscopies, neuro, C-sections and laporoscopic procedures.

Equipment/instruments
You can reduce sharps injuries and meet OSHA guidelines that require "no-hands procedures in handling contaminated sharps" with Hands-Free Transfer Drapes from Xodus Medical. Place these single-use drapes within the sterile field so staff and surgeons can simply lay down instruments and pick them up safely. The drapes are available in 16" x 10" or 16" x 20" sizes, with or without a non-magnetic neutral transfer zone.

Diagnostic
If your center offers ultrasound services, Advance Medical Designs's Probe Kovers are a new line of ultrasound probe covers. The ends of the covers are three-dimensional, conform better to the shape of probe and provide an improved fit. Ultrasonic transmission gel packs are included.

Small incisions
For small incisions and catheterizations, the Viscot Surgical Drape is a plastic drape you can see through. Adhesive around the fenestration keeps the drape from sliding off, and a fabric strip absorbs fluid. The drape's breakaway feature eliminates the need for sterile scissors to remove the drape once the procedure is complete.

Reusable drapes?
Might reusable drapes return to the OR? Today's textile drapes are nothing like the ones used before the single-use disposables found in most facilities today, says Bill Carroll, the executive director of the American Reusable Textile Association (ARTA).

"Maybe you think of muslin or cotton, but textile drapes are made of Goretex or a similar fabric that offers excellent barrier protection," he says.

One benefit of reusable textiles in the OR is cost savings, says ARTA. The organization offers the example of a surgical gown, which may cost $4 in a non-woven disposable. Its cost-per-use is the purchase price plus administrative costs and disposal costs. The total cost-per-use is $4.65. The textile gown costs $60 and must be laundered, sterilized and packed after each use. However, after 50 uses (typically a textile surgical product can be used 50-100 times), the textile cost-per-use is $2.25, less than half of the cost-per-use of the paper gown.

Another benefit of textile products is that they can be customized to your surgeons' specific needs, then reused by that surgeon many times.

Hundreds of laundries can reprocess textile drapes for an OR facility in a cost-efficient way, says ARTA. They suggest that the reason many facilities haven't tried reusable textiles is that facility mangers don't know it's a practical option - and they may be right.

"We've never considered reusable drapes, but no one has ever approached us about it," says Terry Johnston, RN, the materials manager for the Dul-aney Eye Institute in Maryland. "We do like things that are cost-effective, and if it would work for our surgeons and patients, we would consider it."