ISPUB.COM The Internet Journal of Surgery Volume 28 Number 5 1 of 4 Use Of Towel Clips As Skin Retractors In Surgery B Tabowei, B Kombo, G Mukoro Citation B Tabowei, B Kombo, G Mukoro. Use Of Towel Clips As Skin Retractors In Surgery. The Internet Journal of Surgery. 2012 Volume 28 Number 5. Abstract Surgical practitioners are faced with challenges in developing countries and these include provision of surgical instruments. Innovations could make up for lack or absence of surgical instruments already in use. The aim is to evaluate the use of towel clips as an alternative for skin retraction. Towel clips were used as skin retractors during exploratory laparotomy for a ruptured appendix in an obese patient, following non-availability of an adequate retractor. The maneuver was to retract the skin for adequate exposure of the operating field. It showed that towel clips could be used adequately as depicted in the pictures and possibly for other operations, where retractors may not be available. Skin retraction could be one of the uses of towel clips, and should be tried in places where other instruments are not available, keeping in mind the contraindications. INTRODUCTION One of the cardinal points for a good surgical procedure is adequate exposure of the operating field. This allows the surgeon to have a good access to the tissues and enables him to handle the tissues/organs with care. A study has demonstrated that optimal exposure, which is safe and reliable, is a routine requirement for surgery 1 , while another one stated that adequate exposure is paramount in abdominal surgeries 2 . A number of instruments have been fabricated to meet this need. Some are self-retaining 1 while others are not. In many hospitals in third world countries, instruments for surgical procedures are lacking. Instruments such as skin grafting knives, pneumatic tourniquet, and retaining retractors, both simple and self retaining, may be lacking. Where available, they are often old, worn out, and out of the reach of the clinics and hospitals in rural settings. This study is therefore designed to use a Mayo towel clip as a self-retaining retractor especially in skin surgeries and some abdominal operations. When well handled, it could be used in place of a Joules self-retaining retraction in thyroidectomies. This paper aims to highlight the use of Mayo towel clips in wound retraction. TECHNIQUE/METHODOLOGY The towel clips were applied to the skin and subcutaneous tissue as demonstrated in the diagram. The operating field was cleaned with antiseptic solution and draped, while the area for incision was exposed. The incision was made and the skin was retracted with Mayo towel clips as shown in Fig. 1-4. Figure 1 Fig. 1: Ongoing surgery