Prepping and Draping
Title: Prepping and Draping
Author: Troy Teeples MSIV, Tara Hahn MD, Nikko Ronquillo MD, Jeff Pettey MD
Photographer: Troy Teeples MSIV, University of Utah School of Medicine
Keywords/Main Subjects: Draping, prepping, cataract surgery, surgical field
Brief Description: This video demonstrates how to properly prep and drape a patient in preparation for cataract surgery.
Maintaining a clean surgical field is imperative for the prevention of infectious complications such as post-operative endophthalmitis. Although rare, this complication is sight-threatening and every preventative measure should be taken to avoid it. Here we show proper surgical preparation and draping of a patient for cataract surgery.
Description of Technique:
Before arriving to the OR, the surgical eye will have been anesthetized with topical proparacaine and lidocaine gel (note that there are variations in preoperative topical anesthesia protocols at different institutions). In the video, the nurse places a sterile towel over the head. A drop of 5% Betadine solution is then placed to the surgical eye followed by cleaning of the surgical eye, starting centrally and moving peripherally using a Raytec 4×4 sponge. It is important not to return to the eye after cleaning more peripheral areas with the same sponge. The upper eyelid is then gently elevated using a cotton swab and a second swab soaked in 5% Betadine is used to clean the superior then the inferior eyelid margins.
After the eye and ipsilateral face and forehead are cleaned at least three times, the Betadine is allowed to dry for at least 2 minutes (there are institutional differences of how long to wait before draping). For draping, a new sterile blue towel is placed over the forehead and tucked under the head to keep it in place. Next, a 4×4 is used to dry the eyelashes and periorbital area. It is important to dry the eyelids well to ensure that the drapes stick properly. The handle of a cotton swab is then used to elevate the superior eyelid while the patient is asked to look down and the drape is placed directly over the eye and pulled open on both sides. An assistant can be handed the bottom part of the drape, which is snapped over a swan in order to tent the drape up, ensuring that it does not cover the patient’s mouth. Using drape scissors, a slit is cut open medially and extended temporally. Finally, an eyelid speculum is placed.
Faculty Approval by: Jeff Pettey, MD
Disclosure (Financial or other): None