VELCRO ON LAPAROTOMY SHEET Rose Cooper, R . N .

Operating room nurses are fully aware that, clespite the many disposable items used, a great deal of our time is still spent in checking linen and surgical drapes before packs can be made. The use of towel clips to secure suc- tion tubing and cords needed during an oper- ation creates problems in that laparotomy sheets become peppered with holes and need to be patched.

Preventing these small holes i n the first place woulcl resolve this problem, ant1 we set out to eliminate the use of towel clips.

It was felt that whatever could replace the towel clips would have to accomplish two things :

1. It would have to be simple to use. 2. It would in no way hamper any pro-

cedure or be objectionable to the members of the operating team.

At first we thought that a 1-inch wide cot- ton tape sewn on a laparotomy sliret with a loop large enough to draw the suction tubing and the Bovie cord through, might he the answer to our problem. Upon closer scrut.iny, the idea was abandoned. Our reason for aban- doning the sewn on loop was apparent. Should the suction tip or Bovie cord accidentally fall below the sterile field, we would have to cut the loop to remove the contaminated equip- ment. The cut loop would have to be replaced, which meant ripping out the pieces and sew- ing new tape in place. Our initial effort was deemed impractical.

Next, we explored the possibility of sewing

Rose Cosper, R.N., has been surgical nurse in charge of surgery at the Receiving Hospital, L,os Angeles, Cal., for the past four years. Prior to that, Miss Cosper was for many years a surgical nurse in the emergency section of that hospital.

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two pieces of 1-inch wide cotton tape which could be tied together to hold the suction tub- ing and the Rovie cord in place. The idea was that, should accidental contamination occur. such as mentioned, the bows could be untied and the contaminated equipment removed. Frankly. we did not care to stop to tie bows. Besides. those tapes could be accidentallv untied during a procedure arid the cord and suction tubing could fall down below the ster- ile field. The idea too, was discarded as im- practical.

We were stymied. However, our efforts were redoubled when our seamstress brought u5

1-inch wide nylon Velcro and asked if it might help us with our project.

We did little experimenting. The diameter of our suction tubing measures 512 of an inch. This, combined with the Bovie cord led us to adopt the following plan.

Six inches above the fenestration and in the middle of the laparotomy sheet (facing the head of the sheet) a piece of Velcro Pile 1 x 1 1/8 inch is sewn down flat, the second 3 inches above the first. (Figure 1). To the left of each sewn Velcro Pile, a piece of 1 x 2 1/4 inch Velcro Hook is sewn on at one end only, leaving the other end free. (Figure 1). After the tubing and the cords are ad- justed to the surgeon’s requirements, they are “sandwiched” between the two pieces of Vel- cro. The upper piece closes over the lower. (Figure 2 ) . This not only holds the cord and tubing securely, it looks neat with no towel clips on the field to tangle up the tubing and the cords. As soon as the procedure is com- pleted, simply pull on the upper Velcro Hook to separate the two closed surfaces and remove

September 3967 47

Figure 1: The position of Velcro sewn on the laparotomy sheet. T h e Velcro is l e f t open before the sheet is folded fo r sterilizing.

Figure 2: T h e suction tubing and Bovie cord are adjusted to the surgeon’s requirement.

the used equipment. Before the sheets are folded we make cer-

tain that the Velcro Hook is left open. (Figure No. 1). When the sterile sheets are unfolded for a surgical procedure, no time is lost trying to separate the two adhering surfaces.

Since we adopted this system, we had new laparotomy sheets made. We are delighted to see them remain free from holes. The use of

the Velcro device has been so successful that we have applied it on all our large fenestrated sheets as well as the large cover sheets.

Time and effort devoted to this project has been rewa.rding. Velcro, as we applied it, is simple to use and the members of the operat- ing team find it most satisfactory. We are no longer concerned with peppered holes and “patching.”

48 AORN Journal