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Safe Patient Handling and Movement Series
AORN Ergonomic Tool 5:
Tissue Retraction in the Perioperative Setting
PATRICE SPERA, MS, RN, CNOR; JOHN D. LLOYD, PhD, MErgS, CPE; EDWARD HERNANDEZ, BSN, RN; NANCY HUGHES, MS, RN;
CAROL PETERSEN, MAOM, BSN, RN, CNOR; AUDREY NELSON, PhD, RN, FAAN; DEBORAH G. SPRATT, MPA, BSN, RN, CNOR, NEA-BC
ABSTRACT
Manual retraction, a task performed to expose the surgical site, poses a high risk for musculoskeletal disorders that affect the hands, arms, shoulders, neck, and back. In recent years, minimally invasive and laparoscopic procedures have led to the development of multifunctional instruments and retractors capable of performing these functions that, in many cases, has eliminated the need for manual retraction. During surgical procedures that are not performed endoscopically, the use of self-retaining retractors enables the assistant to handle tissue and use exposure techniques that do not require prolonged manual retraction. Ergonomic Tool #5: Tissue Retraction in the Perioperative Setting provides an algorithm for perioperative care providers to determine when and under what circumstances manual retraction of tissue is safe and when the use of a self-retaining retractor should be considered. AORN J 94 (July 2011) 54-58. Published by Elsevier, Inc., on behalf of AORN, Inc. doi: 10.1016/j.aorn.2010.08.031
Key words: tissue retraction, manual retraction, prolonged manual retraction, ergonomic instruments, perioperative traction-related injury.
Editors note: This is the fth in a series of seven articles based on the AORN guidance statement: Safe patient handling and movement in the perioperative setting that describe specic ergonomic solutions for high-risk patient handling tasks in the perioperative clinical setting.
Perioperative team members who function as surgical assistants often are required to retract tissue to expose the surgical site.
Retraction by an assistant provides optimal exposure of the surgical eld for the surgeon. Retracting during a surgical procedure requires the assistant to grip and pull on a retractor or, in some instances, to use his or her hands to expose
doi: 10.1016/j.aorn.2010.08.031
54 AORN Journal July 2011 Vol 94 No 1 Published by Elsevier, Inc., on behalf of AORN, Inc
ERGONOMIC TOOL 5: TISSUE RETRACTION www.aornjournal.org
Figure 1. AORN Ergonomic Tool 5: Tissue Retraction in the Perioperative Setting.
tissue. Retraction is a high-risk task because it requires prolonged standing, trunk exion, neck exion, and arms held higher...