can patients keep their underpants on for surgery

  1. Well, the title says it all. However of course it would depend on where the surgeon will be cutting. If the surgical site is not close to the abdominal, pelvic, upper thigh, etc. area, what do you guys do?

    I often tell patients they can leave their underpants on, for example for breast biopsies. I always tell them in an emergency their underpants may need to be cut off. I've heard one surgeon (who does a lot of breast biopsies) say yes, of course, you can leave your underpants on. But sometimes a co-worker comes along after me and tells the patient, oh no, you HAVE TO take everything off. I also hear something about if the underpants are ??? nylon ??? or something about what the fabric is they can catch fire more easily?
    •  
  2. 27 Comments

  3. by   Rose_Queen
    There's also the need to insert foleys. Don't know about you, but I can't see a thing if the patient still has underwear on.

    Also, people coming in, say for an appy, know the incision is going to be on their abdomen, but we need to prep several inches lower than the incision. That may mean the patient's underwear become stained with the prep solutions, and possibly also irrigation fluids and blood (depending on how messy the surgeon is).

    And sometimes, the patients are extremely relaxed under anesthesia- including sphincter muscles. Having the patient remove their underwear (especially same day surgery) prevents them from having to wear soiled underwear, no underwear, or the mesh "panties" home. If someone is absolutely opposed to taking them off, I won't pressure the patient.
  4. by   ChristineN
    I'm curious about this too. I work with alot of peds pts that are often shy about taking of their underwear. I normally allow the pt to leave underwear on, making sure to tell the family they can leave them on but they may be asked to take them off in pre-op. Is that appropriate?
  5. by   NurseSnarky
    Lately I've been getting surprised in the OR. I should know better and ask, but we run so fast that it's always been up to the pre-op nurse to make sure underwear are off. If there is a need to be down there (i.e. foley), I usually just pull them down to their ankles after induction. Most D&Cs/Hysters want to keep them on for obvious reasons, so I always tell them they can and then they take them off in the OR before getting on the bed, and I bag them in a biohazard bag. Older peds patients seem to almost always wear some sort of shorts over their underwear I swear. If it's abd, etc. I will let them wear them into the OR and get the unders out of the way when they are asleep...unless they are a bigger patient then we will have to work something else out.

    If a patient has to wait until the OR (D&Cs) then I will help them out of them doing a body block with a blanket to give them some privacy...that's why I HATE the dang door opening and closing when people KNOW the patient is in the room! ARGH! Someone forgot SOMETHING and then they forgot TEN things. Just wait five minutes until the patient is asleep and covered. NOTHING and I mean NOTHING gets my blood boiling more than when I have a patient frog legged or up in stirrups and the door opens! I will grab whatever I can and cover them, so I have to glove up again. I'm right handed so I can't always have my back to the door so I can maneuver myself, kwim? These are always my own fears when I've had surgery and if I do again! OY! I suppose those are OT...sorry!
  6. by   canesdukegirl
    When I am ready to prep my pt for surgery and see that they have their drawers still on, nothing makes me more angry. I always have to remove them, and when I have a pt who weighs more than 150 lbs, it is NOT an easy task to remove them. More times than not, I doing this with no help.

    My rationale is that surgery is unpredictable. We never know what course of events will take place. If surgery takes longer than expected, guess who gets to crawl under the drapes and put a foley in? Yep, yours truly. I am NOT going to want to take undergarments off while on my knees trying to keep out of the way of the surgeons, not contaminate anything, and still try to keep some sort of dignity about myself while my butt is bobbing the drapes.

    Underwear comes off.
  7. by   VivaLasViejas
    The visuals on that one are just too funny, canesduke!!
  8. by   lockheart678
    If it's something like a breast biopsy or a port placement, we let patients keep their underwear on. OPS actually tells all patients that everything has to come off, but we still get patients every now and then that really have an issue with taking them off, and I don't blame them. I wouldn't want people to see that if they don't need to. Maybe I just haven't been in the OR long enough, but I've never struggled pulling a patient's underwear off when needed yet, so it doesn't really get to me. What does get on my nerves though is the number of floor patients that we get who end up making it back to the OR with not just underwear on, but pants! I don't care if I don't have to put a foley in, where am I supposed to put that cautery pad! Sometimes I really wonder about our floor nurses, especially when they let their patients come to us with a wallet in their pocket and jewelry still on.
  9. by   NurseSnarky
    Quote from lockheart678
    If it's something like a breast biopsy or a port placement, we let patients keep their underwear on. OPS actually tells all patients that everything has to come off, but we still get patients every now and then that really have an issue with taking them off, and I don't blame them. I wouldn't want people to see that if they don't need to. Maybe I just haven't been in the OR long enough, but I've never struggled pulling a patient's underwear off when needed yet, so it doesn't really get to me. What does get on my nerves though is the number of floor patients that we get who end up making it back to the OR with not just underwear on, but pants! I don't care if I don't have to put a foley in, where am I supposed to put that cautery pad! Sometimes I really wonder about our floor nurses, especially when they let their patients come to us with a wallet in their pocket and jewelry still on.
    Okay that REMINDS me and I need to tell OP...a pt came back for a bleph with his JEANS ON once! I didn't get the pt and he had a blanket on...I pull it back to put the cautery pad on and FRICK!!! Are you serious?!

    Had a two hour scheduled case today for an older peds...I went up to admit and told the nurse to have him remove his unders. She goes, "Oh, I guess they want you to take off your underwear too." Ummmmm....yes please. :heartbeat So we get to the OR and I had to untie his gown and he nearly panicked and said, "they made me take off my underwear". I can untie a gown and not moon anyone. So he was fine.
  10. by   GadgetRN71
    For small quick cases, most of the time they can keep them on but when I worked in a place were we did big cases and trauma, off they came and I didn't mess with trying to pull down underpants on a trauma patient. That's what my scissors are for.

    And yes, we got trauma pts all the time that came to us with underwear, pants etc. Also, apparently the trend is not to put foleys in trauma patients anymore( being sarcastic here). I don't care about putting one in- I'm good at Foleys. But, shouldn't they be monitoring urinary output on a trauma patient?
  11. by   brownbook
    Thanks, I do work out patient surgery, they are many small quick cases, often MAC or TIVA anesthesia. So I feel okay leaving underpants on. Of course ONLY for cases away from the abdominal, pelvic, upper thigh area.

    I will keep in mind the length of the case with the possibility of needing a foley. And I know I hadn't thought about where the cautery pad is going to go.
  12. by   Mr. & Mrs. RN
    Only if they insist, and only if I don't need access down there. For pediatric patients, I try to leave them on if at all possible.
  13. by   TammyOllice
    Yes you can i just had gall bladder removed underwear stayed on
  14. by   TammyOllice
    I wasnt going to have surgery if i couldnt!!

close