Disposable paper/plastic combined drapes (IMS) Poll

RE: Disposable paper/plastic combined drapes (IMS) Poll

Edward Jones — Fri, 28 Jul 2017 15:56:10 GMT

It wouldn't be the first time a vet gets better results using a product is a way completely unintended/unrecommended by the manufacturer...

The drapes work rather well shiny-side up.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Rob Davis — Fri, 28 Jul 2017 15:26:15 GMT

[quote user="Sarah Stokes"]

Glad all you guys are loving our drapes, the correct way is Shiny side down and be assured you will get no strike through.

Sarah Stokes - IMS Equine & Large Animal Business Development Manager

[/quote]

Thank you for clarifying, Sarah. It looks as though Michael and I will have to eat humble pie.....

RE: Disposable paper/plastic combined drapes (IMS) Poll

Evelyn Barbour-Hill — Fri, 28 Jul 2017 14:58:38 GMT

[quote user="Sarah Stokes"]Glad all you guys are loving our drapes[/quote]

It looks to me as if some of the gals are too.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Sarah Stokes — Fri, 28 Jul 2017 14:50:41 GMT

Glad all you guys are loving our drapes, the correct way is Shiny side down and be assured you will get no strike through.

Sarah Stokes - IMS Equine & Large Animal Business Development Manager

RE: Disposable paper/plastic combined drapes (IMS) Poll

Joyce Whitehead — Thu, 27 Jul 2017 17:42:13 GMT

But if you use the shiny side down with the self adhesive ones, nothing goes under the drape as it is stuck down. So it wicks into the non shiny top side. (To play devil's advocate).

RE: Disposable paper/plastic combined drapes (IMS) Poll

Iain Richards — Thu, 27 Jul 2017 16:55:50 GMT

Slack surgery time.

WHO review http://www.who.int/infection-prevention/publications/ssi-guidelines/en/

It looks like there isn't much difference between disposables and non disposables. I guess a problem we encounter is fur, so that it is difficult to apply a drape tight to the skin and fluids can accumulate under the drape.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Michael Woodhouse — Thu, 27 Jul 2017 15:31:31 GMT

Shiny side down and the majority of fluid does wet the patient. It can't wet the patient if absorbent side down as wicked away. We used to use plastic drapes and some got covered in blood.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Iain Richards — Thu, 27 Jul 2017 14:25:12 GMT

Chatting with the RVNs today. Shiny to patient. Strike through refers to fluids and an increased risk of hypothermia, so fluids come out of wound, onto fabric, absorbed, but don't wet patient. I have to admit to thinking that strike through was related to sepsis.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Tricia Goulden — Wed, 26 Jul 2017 21:42:23 GMT

If it helps Rob, I use them shiny side down!

RE: Disposable paper/plastic combined drapes (IMS) Poll

Rob Davis — Wed, 26 Jul 2017 16:44:48 GMT

[quote user="Michael Woodhouse"]

Well, this isn't going in my favour!

[quote user="Iain Richards"]The purpose is to prevent stike through, so I'd say shiny to patient.[/quote]

Well, I do agree, but I think the other way around is best - absorbent side to animal. Any blood or fluid that oozes under the drape is absorbed and doesn't soak the animal. Any viscera goes on a smooth shiny side and don't stick. Strike-through prevented either way.

[/quote]

I'm with Michael here, though I did notice one of my colleagues using one the other way up recently, and now this discussion has turned my life upside down and I have no idea what to do next time I use one....

RE: Disposable paper/plastic combined drapes (IMS) Poll

Rob Loxley — Wed, 26 Jul 2017 13:54:37 GMT

[quote user="Evelyn Barbour-Hill"]Actually I have just been informed that while the "balloon cloth" ones are good, the ones I really like are a slightly heavier material. So I had my terminology wrong, but then the wholesalers often do too.[/quote]

Calico

RE: Disposable paper/plastic combined drapes (IMS) Poll

Evelyn Barbour-Hill — Wed, 26 Jul 2017 12:27:01 GMT

Thanks.

Actually I have just been informed that while the "balloon cloth" ones are good, the ones I really like are a slightly heavier material. So I had my terminology wrong, but then the wholesalers often do too.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Thomas Johnson — Wed, 26 Jul 2017 12:17:34 GMT

[quote user="Evelyn Barbour-Hill"]

I'll stick to nice quality green cotton. Don't care if they do cost more.

Does anybody know why this material is called "balloon cloth"?

[/quote]

I think it was originally produced for use in hot air balloons as a lightweight but very tightly-woven material.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Evelyn Barbour-Hill — Wed, 26 Jul 2017 12:03:25 GMT

I'll stick to nice quality green cotton. Don't care if they do cost more.

Does anybody know why this material is called "balloon cloth"?

RE: Disposable paper/plastic combined drapes (IMS) Poll

Anthony Dennison — Wed, 26 Jul 2017 10:31:14 GMT

[quote user="Michael Woodhouse"]Well, I do agree, but I think the other way around is best - absorbent side to animal. Any blood or fluid that oozes under the drape is absorbed and doesn't soak the animal[/quote]

But then are you not leaving the wet drape next to the skin allowing greater heat loss via conduction through the wet drape as well as convection? Shiny side to patient, the fluid runs off.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Malcolm Ness — Tue, 25 Jul 2017 22:24:33 GMT

[quote user="Michael Woodhouse"] I also may have to concede to our new assistant that I may be wrong.....[/quote]

I was wrong once .......... I thought I had made a mistake, but I was wrong.

RE: Disposable paper/plastic combined drapes (IMS) Poll

Michael Woodhouse — Tue, 25 Jul 2017 21:32:51 GMT

Well, this isn't going in my favour!

[quote user="Iain Richards"]The purpose is to prevent stike through, so I'd say shiny to patient.[/quote]

We used to use disposable plastic drapes, but animals got very messy as blood and fluids run off into fur. These keep things clean (like cotton/calico) and prevent strike through (like plastic). I did some sums costing time to purchase, wash, launder, sterilise reusable drapes an disposables are a 'no brainer'.

Clearly I'm in the minority. I may email IMS and see what they recommend! I also may have to concede to our new assistant that I may be wrong.....

RE: Disposable paper/plastic combined drapes (IMS) Poll

Beats — Tue, 25 Jul 2017 20:00:21 GMT

[quote user="Iain Richards"]What's the evidence?[/quote]

For sticky drapes and plastic drapes, it's controversial as I understand it.

Microbial overgrowth during prolonged procedures on adjacent skin under occlussive drapes is believed to be a potential problem in people as I understand it (who sweat).

When doing ops with copious flushing, I personally like a plastic drape (I use Buster covers) over top of everything to prevent soaking of cloth/paper drapes below. I do use iodine-impregnatned sticky drapes in ortho ops, but I understand that techniuqe of application is important and some controversy exists as with any of sticky-drapes - personally I find them easy to stick on well to ventral abdomen (and occasionally do, eg for some cystotomy), but difficult to apply correctly to a limb...

From Vet Clinics North America Small Animal (2015) 45(2):243-276:

No effect157,158 of incise drapes on reduction of SSI rate, non–iodophore-impregnated incise drapes may even increase the risk of SSIs,157,158because of higher bacterial regrowth under the drape158 • Application technique is important, lifting of the edges of adhesive drapes may enhance bacterial contamination159 If used, use iodophore impregnated with proper application technique	• No trial available
Veterinary recommendations	Do not use routinely; if used, use iodophore impregnated with proper application technique
surgical site preparation: plastic buster-type drapes
	• Pure plastic draping is not used in human medicine; no trials available	Plastic buster-type drapes are widely used in veterinary medicine. Although there are no trials available either on the difference between SSI rates or on the bacterial growth potential underneath buster-type plastic drapes and conventional woven reusable or disposable drapes, evidence from human medicine shows substantial increase in bacterial regrowth under plastic drapes. Increased moisture retention near the skin could facilitate bacterial growth.158 Clinical experience shows that patients often sweat profusely under these drapes. Plastic buster drapes are therefore not recommended
Veterinary recommendations	• Until further evidence with regards to their safety is available, their use should be abandoned

RE: Disposable paper/plastic combined drapes (IMS) Poll

Anthony Dennison — Tue, 25 Jul 2017 14:22:04 GMT

I also use them, the one with the sticky edge. With cat spays I'll unpeel the sticky bit and then stick it to the top of the cat or the table just above the cat (in a sterile manner of course) and it removes the need for towel clips and it doesn't move around.

I tried the fully adhesive see-through ones you make an incision through from IMS too just to see what it was like. Didn't get on with them at all!

RE: Disposable paper/plastic combined drapes (IMS) Poll

Iain Richards — Tue, 25 Jul 2017 09:26:13 GMT

Michael, you've missed off, "What's wrong wi' t'owd cotton drapes" and, "Drapes is for wusses"

Although I've recently had this chat in a practice with the nurses. The purpose is to prevent stike through, so I'd say shiny to patient. However, I personally find them a bit too stiff to use effectively and they end up sliding around and exposing more un-prepped skin. I don't like towel clips feelling they are too traumatic.

What's the evidence?

RE: Disposable paper/plastic combined drapes (IMS) Poll

Julie Innes — Tue, 25 Jul 2017 08:46:53 GMT

I'm a fan of these too, Michael!

RE: Disposable paper/plastic combined drapes (IMS) Poll

Linda Filshie — Mon, 24 Jul 2017 22:20:32 GMT

[quote user="Joyce Whitehead"]

I have voted for the way I use them when we have these, but I really like the Ines with a self adhesive edge to the fenestration, as it sticks nicely to the clipped area, keeeping things tidy, and rarely need towel clips. (Also from IMS).

[/quote]

I am also a lover of the self-adhesive ones, although you have to ask your nurses to ease off on the over-enthusiastic spraying of surgical spirit etc or you have to wait ages for them to dry before they will stick!

If you have the adhesive ones it's blatantly obvious that they should go shiny side to patient. Why on earth would you want it absorbent on the patient side anyway?!

RE: Disposable paper/plastic combined drapes (IMS) Poll

Joyce Whitehead — Mon, 24 Jul 2017 22:17:18 GMT

I have voted for the way I use them when we have these, but I really like the ones with a self adhesive edge to the fenestration, as it sticks nicely to the clipped area, keeeping things tidy, and rarely need towel clips. (Also from IMS).

RE: Disposable paper/plastic combined drapes (IMS) Poll

Beats — Mon, 24 Jul 2017 22:08:55 GMT

loving the recommendation of a new type of drape to try out, but can't help with the question :-)

Had a similar one when in mixed practice - boss extolled the brilliance and remarkable healing properties observed when applying expensive silver dressing on horses wounds at £10 a sheet or something nuts, new grad read the instructions and put it the other way round... boss corrected her after changing one of her redresses... new grad showed him the instructions...