What’s the evidence for type of surgical drapes?

The primary purpose of draping the surgical patient is to isolate the surgical site from the other areas of the patient’s body and nonsterile areas of the operating table in order to contribute to reducing the risk of surgical site infection. The drapes serve as a barrier to the patient’s skin flora (endogenous contamination) which is identified as a major source of wound contamination. Particularly in horses where the body surface is extremely large, the amount of shed of particles is likely a multiplication of that found in humans.

When choosing drape materials, several aspects have to be taken into account. Firstly, disposables versus non-disposables. Based on an evaluation of the functional requirements, environmental impact, and economics of gowns and drapes, clear superiority of either reusable or single-use gowns and drapes cannot be demonstrated. Some studies show superiority for non-woven to reduce SSI rates compared to woven fabrics. However, met-analysis concludes there is lack of definite evidence to whether or not differences in SSI rates between the two types of drapes exist. It is therefore to the surrogate outcome of bacterial contamination – reduction that one needs to focus in order to make a decision. In that sense, disposable drapes result in lower particle counts in the operating room (because of the lack of lint from cotton) and decrease the number of bacteria isolated from the surgical wound by up to 90% compared with the cloth draping systems. When looking at the primary function of a drape; i.e. isolate the surgical wound from the surrounding endogenous source of contamination, woven re-useable drapes fail this purpose. Woven drapes are ineffective fluid barriers, but also in dry condition strikethrough occurs within 30 minutes of exposure. Once wet heavy staphylococcus and streptococcus contamination on the surface occurs. In general, disposable drapes are also bigger in size than reusable drapes which offer significant advantage in equine surgery. Even though the cost of single-use drape sets is higher than for reusable sets, single-use sets provide the highest benefit rates. [...]