THE CHANGING OF THE GUARD – ISSUE NO. 199

I can still remember wrapping my first OR tray. I pulled the blue surgical towel and placed it under the tray and wrapped. The first tray I assembled was a general surgery basic tray. I lined the tray with a blue surgical towel and off I went. It wasn't until some time later I asked, "Why was I using these towels?" I was told they were used inside the trays to help protect sharps and other instruments from poking through the bottom of the tray. We had some sterilizer issues and the tray would not be wet or have water in them after sterilization. The towels under the tray helped prevent little tears or holes in the wrapper. It all made sense to me. Oh, they also had lint rollers for me to delint the towels each time before I used them. Oh, those were the days The reason I bring this up is we had a story this week about surgical towels. It stated that hospital laundering practices appeared to be insufficient in removing microbial contaminants and may even add contaminants to the surgical towels. This made me remember a story that Outpatient Surgery reported in the October 2011 Issue that, "... damage occurred sterilizing stainless steel surgical instruments and titanium implants when the hospital's staff used OR towels cleaned by the linen service. The towels were wrapped around the devices, which were then put through a steam autoclave. At the end of the process, the OR towels had crumbled and some of the medical instruments they were wrapped in were discolored and had to be discarded..." An expert stated in court documents that "...traces of an acid that a linen service used to clean operating room towels have discolored and damaged surgical instruments...". I now add the information to that of Dr. Wava Truscott ( Director of Scientific Affairs and Clinical Education for Kimberly Clark) who frequently speaks on: lint and the problems it can create within a OR theatre for a patient. It might be time to rethink using OR towels inside a surgical tray or as a liner to prevent tearing. The dots are starting to connect. The point is that surgical towels are meant for wiping hands and their intended use is not for lining or protecting surgical tray. The evidence to me is saying we might need to maybe have a "changing of the guard" to something else than reusable towels for these task. What do you think?