[truern]

I'm a 2nd semester ADN student and I had the opportunity to go to surgery with my patient recently. She was having a revision of her hip replacement because she'd fallen the week before and damaged some of the hardware.

Imagine my surprise when the surgeon began stapling the first drape to the patient's abdomen and flank!! At first I thought I was seeing it wrong, but INDEED that's what happened. Then I thought there must be some "special" tool to remove those staples, but when the surgery was over he simply pulled the drape loose?!

Is this a common practice?? The nurse told me that he's the only one she's seen do it and she lets him remove the drapes because it "grosses" her out

I realize it's a sterile drape and sterile staples, but surely there's no reason to cause unnecessary punctures and sites for soreness??

[Marie_LPN]

It's not common practice where i work, even in ortho, and the chief surgeon said that's a big "no-no".

[truern]

I asked a neurosurgeon who happened to be in the foyer today and he said he used to do it before they had the sticky drapes, that it was the best way to maintain a sterile field back then.

Thank god for sticky drapes

[Marie_LPN]

We have the sticky drapes, which is why it's a no-no now.

[Charity]

We must not have the sticky drapes in our OR, because I see those tell-tale holes and occasionally leftover staples in patient in the post-op patient all the time in my hospital. I have never seen any additional swelling, redness or bleeding resulting from those sites, however.

C

[carcha]

yeah, we used to have that, but rarely now. Now I've only seen it done if the surgeon feels the sticky drape may "crinkle" up, in areas such as the shoulder, neck, ect. However as I said its rare. When they finish though they use a staple remover however you can see the marks. Cant say I've had feedback from it though, interesting.

[orrnlori]

Wow - I guess it depends on the area of the country you practice in. We staple quite a bit. But when I'm scrubbed, I always insist on removing the staples myself so they are removed correctly. When done right, you can rarely see marks bigger than a pin prick and many times, no marks at all. I've not heard of any infections reported from stapling. Might be a good research question. Sticky drapes can come undone when wet or damp from blood and irrigation leaving surgical fields, instruments and the patient exposed to unprepped and unsterile areas and fluids. If I were the patient, I'd rather have the staple marks for two days than risk infection from contamination from loose sticky drapes. And I've also seen some real skin irritations from reactions from the adhesive on drapes and tape. Just my .02.

[mcmike55]

Reading your thread was a bit of a "blast from the past" for me.
We also, in the past, stapled drapes at times. Most of the time it was just a cloth towel or two, and usually only when something else didn't work, and a drape moving would be "a bad thing"!!
Now-a-days, I can't remember when we have stapled a drape, the sticky drapes, and incision drapes, etc work so much better.
But yes, we used to do it too.

[MelissaRN]

I've seen docs staple the drapes to the patients too. My big fear is forgetting about the staples and ripping the drape off. We have the sticky drapes and clip towels to the drape with towel clips. I also saw a doc staple Tegaderm dressing to a patient's head when I was working on the floor. I was horrified.

[mare-mare]

I cringe everytime I see a surgeon staple a drape to a patient, but by and large only our general surgeons do it. They say that sticky drapes just don't cut it and they want the towels to stay where they put them. We kid that a general surgeon can't perform surgery without a stapler and our orthopods don't know which end of a stapler to use.