Towel clamps are common surgical instruments used in virtually every operating room procedure. Though simple in design, they are fundamental tools for maintaining organization and safety. Their primary function is to hold materials firmly and securely together, establishing a fixed barrier or anchoring point necessary for preparing the surgical field and managing equipment.
Physical Structure and Mechanism
The design of a standard towel clamp, such as the widely used Backhaus model, is similar to specialized forceps. It features finger rings for control, which transition into long shanks that transmit the closing force to the working end.
Near the finger rings is the ratchet mechanism, a series of interlocking teeth that allow the clamp to lock shut once pressure is applied. This self-retaining lock ensures the instrument maintains a constant, non-slip grip without requiring continuous manual pressure. The working end consists of two jaws that curve inward, terminating in sharp, pointed tips designed to penetrate and hold material. The clamp remains securely fixed until the handles are actively squeezed again to release the lock.
Securing the Sterile Field
The most recognized use of the towel clamp is establishing and maintaining the sterile field, a zone free from microorganisms. Before an incision is made, the surgical team places specialized cloths, known as surgical drapes, over the patient’s body to isolate the operative area. These drapes create a sterile barrier separating the surgical site from the surrounding non-sterile environment.
Towel clamps are employed to anchor these drapes firmly to the patient’s skin or to each other, preventing movement that could compromise the sterile barrier. Penetrating clamps, like the Backhaus, pierce through the drape material and often a small amount of the patient’s skin. This penetration ensures an unyielding hold, which is necessary for patient safety during a procedure.
A secure anchor is necessary because shifting drapes could expose non-sterile areas, risking contamination and surgical site infection. The constant tension and movement inherent to a surgical procedure require the utmost stability in the sterile coverings. By locking the drapes in place with the ratchet mechanism, the towel clamp preserves the integrity of the aseptic environment throughout the operation.
Specialized Types and Auxiliary Uses
While the Backhaus is the most common penetrating type, other variations accommodate different surgical needs. The Roeder clamp, for instance, incorporates small spheres near the tips to limit the depth of tissue penetration. Conversely, the smaller Jones towel clamp is often preferred in delicate procedures, such as eye surgery, and frequently uses a spring-loaded mechanism instead of a ratchet.
Non-Penetrating Clamps
Other specialized models are non-penetrating, meaning their tips grip without piercing material or tissue. Non-penetrating clamps, such as the Lorna or Edna clamp, are used primarily for securing equipment lines without creating holes in the sterile drapes. These clamps manage various cables and tubing within the sterile field, keeping them organized and out of the way.
Auxiliary Applications
Beyond securing drapes, towel clamps have several auxiliary applications in the operating room. They are frequently used to anchor equipment to the edge of the sterile field, preventing dragging or entanglement. Surgeons also employ them for temporary management during complex procedures.
Auxiliary uses include:
- Holding suction tubing, electrocautery cables, and light cords.
- Temporarily managing or retracting soft tissue during dissections.
- Holding small bone fragments in place.