Objective and Management OT IV

Subject: Medical and Surgical Nursing II (Theory)

Overview

In order to establish and maintain a sufficient sterile field during operation, draping is the process of covering a patient and enclosing the regions with a sterile barrier. A nurse must separate the unclean from the clean and the opposite (for example groin, colostomy and equipment from the area to be prepped). An impermeable drape, often made of plastic material, is used for isolation. Materials for drapes are chosen to create and maintain a strong barrier that reduces the movement of pathogens between sterile and non-sterile locations. Basic attributes of surgical drapes include abrasion resistance, barrier properties, biocompatibility, traceability, electrostatic properties, non-flammability, tensile strength, and others. All surgical drape fabrics should have these qualities regardless of the materials used. Reusable drapes, disposable drapes, plastic incisional drapes, standard drapes, and a perineal drape are several types of drapes.

Draping

In order to establish and maintain a sufficient sterile field during operation, draping is the process of covering a patient and enclosing the areas with a sterile barrier.

Isolate

A nurse must separate the unclean from the clean and the opposite (for example groin, colostomy and equipment from the area to be prepped). An impermeable drape, often made of plastic material, is used for isolation.

Barrier

This provides an impervious layer and must have a plastic film to prevent a strike-trough.

Sterile Field

The creation of the sterile field is through a sterile presentation of the drape and aseptic application technique. If the drape used is not impervious layer needs to be added.

Sterile Surface

Since the skin could not be sterilized, it is needed to apply an incise drape to create a sterile surface. Only an incise drape to create a sterile surface.

Equipment Cover

Non-sterile tools used in the sterile field are covered with sterile curtains. This serves to safeguard and extend the life of the equipment as well as to protect the patient from the equipment.

Fluid Control

A fluid collection keeps the patient dry, lowers worker exposure, and facilitates cleanup. Anytime a procedure is known to involve significant amounts of body fluids or an irrigating solution, like TURP, a fluid control system should be used.

Draping materials are selected to make and maintain an effective barrier that lessens the passage of microorganisms between non-sterile and sterile areas. There are also basic characteristics of surgical drapes, all surgical drape materials should possess these traits regardless of which materials are utilized:

  • Abrasion resistance
  • Barrier properties
  • Biocompatibility
  • Drapeability: The ability of a material to conform to the shape of the object over which it is placed.
  • Electrostatic properties
  • Non-flammability
  • Non-linting: Materials for draping should not contain or generate with normal use, free fiber particles.
  • Tensile strength

Types of Drapes

  • Reusable Drapes:

The biggest issue with reusable curtains is their lack of fluid permeability when in use. Compared to drying and ironing, steam sterilization and washing cause the cloth to swell. This cycle makes it more likely that fibers will become loosened and change the structure of the fabric. 75 laundry or sterilization cycles typically result in a loss of barrier quality, according to manufacturers.

  • Disposable Drapes:

The collection, transportation, and storage of waste materials are issues with disposable drapes. Disposable waste can be destroyed by burning or incineration, but this process needs to be carefully controlled to avoid contaminating the environment.

  • Plastic Incisional Drapes:

Impermeable polyvinyl sheetings are available in the form of sterile prepacked surgical drapes. The incision is directly made through the adherent plastic drape. This type facilitates draping or irregular body surfaces as neck and ear regions, extremities and joints.

  • Standard Drapes:

A accumulation of liquids keeps the patient dry, reduces exposure to medical personnel, and clarifies teachings. Standard drapes are full or simple sheets that are used to conceal body parts, operating tables, and instrumentation. The sheet needs to be big enough to leave enough space between the prepared operating area and the actual surroundings around it. Patients are draped using fenestrated or slit sheets. For the (laparotomy draping) abdomen, chest, flank, back, and other sizes for limb, head, and neck, they leave the surgical site exposed. n up. Anytime a technique is known to include significant volumes of bodily fluids or an irrigating solution, like TURP, a fluid management device should be implemented.

  • A Perineal Drape:

When doing procedures on the genitalia and perineum while the patient is in the lithotomy posture, a perineal drape is used. This is made up of two triangle-shaped leggings and a sheet with windows.

Draping Procedure

  • Draping is always done by draping the closest region first and moving from a sterile location to an unsterile area.
  • The scrub nurse must never drape over an unsterile area.
  • The scrub nurse must approach the bed to drape when the opposite side of the operating room bed has to be done.
  • Do not shake, fan, or flip the curtains. Drapes that move quickly can cause air currents on which particles like dust, lint, and droplet nuclei can flow.
  • Shaking a drape causes it to move erratically and might come into touch with an unclean surface or item.
  • Carefully open a drape and let it to gradually fall into place using gravity.
  • Never elevate or pull back onto the sterile area the low section of a sheet that is below the safe working level.
  • Wrap first the incisional region, then the surrounding area.
  • To secure tubing and other items on a sterile field, use non-perforating towel clamps or other devices.
  • Consider a drape to be contaminated if its sterility is in doubt.
Things to remember
  • In order to establish and maintain a sufficient sterile field during operation, draping is the process of covering a patient and enclosing the regions with a sterile barrier.
  • A nurse must separate the unclean from the clean and the opposite (for example groin, colostomy and equipment from the area to be prepped).
  • An impermeable drape, often made of plastic material, is used for isolation.
  • Materials for drapes are chosen to create and maintain a strong barrier that reduces the movement of microorganisms between sterile and non-sterile areas.
  • Basic attributes of surgical drapes include abrasion resistance, barrier properties, biocompatibility, traceability, electrostatic properties, non-flammability, tensile strength, and others. All surgical drape fabrics should have these qualities regardless of the materials used.
  • Reusable drapes, disposable drapes, plastic incisional drapes, standard drapes, and a perineal drape are several types of drapes.
Questions and Answers

Drapes That Are Reusable
The main issue with reusable drapes is fluid impermeability under use conditions. Steam sterilization and laundering cause the fabric to swell, whereas drying and ironing cause the fibers to shrink. This cycle increases the likelihood of loosened fibers altering the fabric structure. After 75 laundry or sterilization cycles, most manufacturers report a loss of barrier quality.

Drapes That Are Disposable
The issue with disposable drapes is waste collection, transportation, and storage. Burning or incineration is a method of destroying waste disposables, but it must be managed properly to avoid environmental contamination.

Drapes with plastic incisions
In the form of sterile prepacked surgical drapes, impermeable polyvinyl sheetings are available. The cut is made directly through the adherent plastic drape. This type makes draping or irregular body surfaces such as the neck and ear regions, extremities, and joints possible.

Typical Drapes
Standard drapes are used to cover instrumental tables, operating tables, and body regions. The sheet should be large enough to provide a safe buffer between the physical environment and the prepared operative field. Draping patients is done with fenestrated or slit sheets. They leave the operative site exposed for abdomen, chest, flank, back, and other sizes for limb, head, and neck (laparotomy draping).

A Drape for the Perineum
A perineal drape is used for perineum and genitalia operations while the patient is in a lithotomy position. This outfit is made up of a fenestrated sheet and two triangular leggings.

  • Draping is always done from a sterile area to an unsterile area, with the nearest area draped first.
  • The scrub nurse should never drape over an unsterile area.
  • When the scrub nurse needs to drape the opposite side of the operating room bed, she must go around the bed.
  • Drapes should not be flipped, fanning, or shaken. Drapes moving quickly create air currents in which dust, lint, and droplet nuclei can migrate.
  • Shaking a drape causes uncontrolled motion, which may result in contact with an unsterile surface or object.
  • A drape should be carefully unfolded and allowed to fall into place naturally by gravity.
  • Never raise or lift the low portion of a sheet that is below the safe working level back onto the sterile area.
  • Drape the incisional area first, followed by the periphery.
  • To secure tubing and other items on a sterile field, use non-perforating towel clamps or devices.
  • Consider a drape contaminated if its sterility is in doubt

© 2021 Saralmind. All Rights Reserved.