Surgical Draping Methods
Clinical Objective
Correctly apply sterile surgical drapes to isolate the prepared surgical site from the patient's surrounding (non-sterile) body surfaces, equipment, and the environment. Proper draping is the final physical barrier between the prepared field and contamination.
Protocol Steps
- 1
Confirm that the prepared skin surface is completely dry before applying drapes.
- 2
Open drape packs using aseptic technique; hand sterile drapes to the scrubbed surgeon without contaminating the package interior.
- 3
Apply fenestrated or towel drapes beginning at the prepared site and working outward.
- 4
Secure drapes to patient with towel clamps at four cardinal points before applying the field drape.
- 5
Ensure the drape fenestration (opening) is correctly aligned with the incision site and of adequate size.
- 6
Do not reposition drapes once placed — repositioning disrupts the sterile barrier.
- 7
Cover all non-sterile surfaces, including the anesthetic circuit lines and monitoring equipment attachments.
Key Pitfalls to Avoid
Repositioning drapes after placement to 'correct' the alignment — this drags contaminated surface under the sterile field.
Using drapes with holes, tears, or moisture strike-through, which provide a pathway for microorganism migration.
Insufficient drape extension — leaving non-sterile patient surfaces exposed near the field.
Allowing drapes to contact the floor, which immediately compromises their sterile status.
I have seen SSIs traced directly to a single draping error — a repositioned clamp that dragged non-prepped skin edge under the field. The rule that drapes, once placed, are not moved is absolute. If the alignment is wrong, the correct action is to add a supplementary drape, not to shift the original. Plan the placement before you commit; once the drape is on the patient, it stays.