AORN Ergonomic Tool 5: Tissue Retraction in the Perioperative Setting.

Area of Science:

• Surgical Technology
• Occupational Health
• Perioperative Medicine

Background:

• Manual retraction is a common surgical task to expose surgical sites.
• This task poses a significant risk for musculoskeletal disorders (MSDs) in healthcare professionals, affecting the hands, arms, shoulders, neck, and back.
• Minimally invasive and laparoscopic surgery have driven the development of advanced instruments that reduce the need for manual retraction.

Purpose of the Study:

• To provide perioperative care providers with an algorithm for safe tissue retraction.
• To guide decisions on when manual retraction is acceptable and when self-retaining retractors should be used.
• To promote ergonomic practices and reduce the incidence of MSDs in surgical settings.

Main Methods:

• Development of a decision-making algorithm for tissue retraction.
• Review of current surgical practices and instrument advancements.
• Focus on ergonomic principles in the perioperative setting.

Main Results:

• The algorithm assists in determining the appropriate use of manual versus self-retaining retractors.
• Identifies circumstances where manual retraction can be performed safely.
• Highlights the benefits of self-retaining retractors in non-endoscopic procedures.
• Minimally invasive techniques have decreased reliance on manual retraction.

Conclusions:

• Self-retaining retractors are valuable tools for minimizing risks associated with manual retraction.
• Implementing the provided algorithm can enhance surgical ergonomics and patient safety.
• The study supports a shift towards more ergonomic retraction methods in surgery.