Retractors | Instruments at a Glance

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(About Retractors)

(About Retractors)

Instrument usage: Retractors are used to hold back wound edges, anatomical structures, or tissue in effort to provide exposure of the operative site.¹ Retractors come in many different shapes and sizes depending upon their use and the needed size during the specific procedure.

Key differences:

Retractors can be manually held (ridged or malleable) or be self-retaining, and even attach to the OR bed.^1,2

Manual retractors that are ridged have a handle and a blade that comes in various widths and lengths to accommodate the size and depth of an incision.²

Some manual retractors can have prongs and be sharp or dull, such a Volkman rake retractor.²

A very commonly used retractor, the Army Navy retractor, has blades at both ends with the handle in the middle.

Malleable retractors are flat and can be bent into position to fit any angle and depth.²

Self-retaining retractors, such as the Weitlander retractor and Balfour retractor, do not need to be held by an assistant during the surgical procedure.²

Self-retaining retractors that attach to the OR bed are stabilized by being clamped to the bed and often contain different size blades and attachments.²

Safety on the sterile field:

Retractors are heavy instruments and should be placed at the bottom of the instrument tray, so that they do not damage delicate instruments.²

It is important not to place the retractor on tissue when not retracting, since it can damage tissue due to the weight of the retractor.²

Retractors are commonly used in pairs, so two of the same retractors should be placed on the mayo stand.²

When passing a retract that is sharp, a neutral zone or hands-free technique should be used so that the scrub personnel uses a no-touch technique.³

Some retractors, such as a Balfour retractor come with multiple pieces that must all be counted.

Instrument names:

Retractors are usually called by their instrument name, such as an Army Navy retractor would be called “Army Navy” or a Balfour retractor would be called “Balfour.” Sometimes, they will be called by their type of retractor, such as “self-retainer.”

References:

1. Rothrock, Jane C. Alexander's Care of the Patient in Surgery-E-Book. Elsevier Health Sciences, 2018.

2. Phillips, Nancymarie. Berry & Kohn's Operating Room Technique. Elsevier Health Sciences, 2016.

3. Guidelines for Perioperative Practice. Sharps Safety. AORN, Inc, Denver, CO; 2021