DRAPING THE PATIENT
a. The procedure of covering a patient and surrounding areas with a sterile
barrier to create and maintain a sterile field during a surgical procedure is called
draping. The purpose of draping is to eliminate the passage of microorganisms
between nonsterile and sterile areas. Draping materials may be disposable or
nondisposable. Disposable drapes are generally paper or plastic or a combination and
may or may not be absorbent. Nondisposable drapes are usually double-thickness
muslin. Drapes, of course, must be sterile.
b. Since draping is very important in preparing a patient for surgery, it must be
done correctly. The entire surgical team should be familiar with the draping procedure.
The scrub must know the procedure perfectly and be ready to assist with it. During the
draping procedure, the circulator should stand by to direct the scrub as necessary and
to watch carefully for breaks in sterile technique.
(1) The illustrations in Figures 3-12 and 3-13 show disposable paper
drapes. The first step in draping is the placing of a drape sheet from the foot to the
knees. The scrub will select the sheet and hand one end to the surgeon across the
operating table, supporting the folds, keeping it high, and holding it taut until it is
opened, then drop it (open fingers and release sheet). The second drape sheet is
handled in the same manner. This sheet is placed below the incision site with the edge
of the sheet just below the incision site. This draping sheet provides extra thickness of
material under the area from the Mayo tray to the incision where instruments and
sponges are placed. It also closes some of the opening in the laparotomy sheet, if
(2) When disposable drapes are used, the towels usually have a
removable strip with an adhesive on the folded edge. The third step in draping is
placing the four sterile towels around the line of incision. The scrub unfolds first towel,
passes the towel drape to the surgeon with the strip side facing the scrub, and then
removes the adhesive strip. The surgeon places the towel within the scrubbed area on
the near side of the line of incision, leaving only enough exposed skin for the incision.
The second towel is placed in the same way, except the towel is placed on the lower
side (toward feet) of the line of incision. The third towel is passed the same way, except
the towel is placed on the upper side (toward head) the line of incision. The last towel is
passed to the surgeon with the adhesive strip facing the surgeon and is placed on the
far side of the line of incision. The adhesive area holds the towel drapes in place.
NOTE: The only procedure changes that are made with nondisposable, muslin drapes
(for example, hand towels) are as follow. The towels are cuffed by the scrub about 3
inches and the folded edge goes next to the line of incision. The first three towels are
cuffed toward the scrub; the fourth towel is cuffed toward the surgeon. The towels are
held in place by towel clips rather than by adhesive.