Learning topic: Assist after surgery

1 © NSW DET 2007

Wrap and package surgical instruments and theatre linen

The type of packaging used greatly influences the maintenance of the sterility of the autoclaved items.

Muslin was once commonly used in surgical linen articles such as drapes and gowns but it is a loosely woven cotton fabric with 140 threads per 2.5cm.

Today woven cotton fabrics produced for surgical use have a tighter weave with 270 threads per 2.5 cm (270 prima cloth). This cloth is usually treated with Quarpel, a water repellent chemical. The weave of the cloth deteriorates with washing. Rips and tears should be repaired with heat-sealed vulcanised patches.

Other modern types of packaging material are impervious to water, and in the right conditions, have a long shelf life.

Different types of packaging are also required for different methods of sterilisation.

The table below shows the different types of packaging and their special features:

Different types of packaging Features

linen wraps or drapes • double linen wrapping of packs should be used

• susceptible to moisture

• deteriorate with continued use

autoclave paper • impervious to water but allows steam penetration—can also be used as draping material

• special autoclave paper bags with chemical indicators on the outside are also available

• can also be used as a draping material

peel down wraps • comes on a reel in varying widths and is cut to size

• can be heat sealed

• have a chemical indicator

• not reusable

Learning topic: Assist after surgery

2 © NSW DET 2007

• ideal for single instruments

• impervious to moisture during storage

autoclave nylon bags • come on a reel and in varying widths

• ideal for single items or whole packs

• limited re-use

• can be heat sealed

• impervious to moisture during storage

metal drums and boxes • ideal for bulk autoclaving of items—eg gauze squares

Wrapping and packaging techniques There are several wrapping and packaging techniques that you need to master:

• folding linen drapes, both plain and fenestrated—those with a central hole—Concertina folding is a common method used

• folding surgical gowns

• double wrapping linen around a surgical pack—the envelope method of wrapping could also be used.

• making up instrument packs for routine procedures––packs should not be so bulky as to impede steam penetration.

• sealing and identifying pack––this may include heat sealing or autoclave tape. The date and contents of each pack should be written on some masking tape. Avoid writing in biro on the outside of paper packaging as this makes holes in the packaging.