Backhaus Towel Clip
The Backhaus is a sharp, penetrating towel clamp with curved points and a locking handle. It can hold draping material or selected tissue, but the points create punctures. Its presence on a tray does not mean every drape should be fixed through the patient's skin.[1][2]
Design and Variants
- Jaws. Two curved, sharp-pointed jaws that meet when the clamp closes and grip drape material between the points.[1]
- Lock. A ratcheted box lock holds the clamp closed, and ring handles allow single-handed use.
- Material and size. Reusable stainless steel is typical. Overall length varies by model, and smaller versions exist for pediatric and delicate cases.
- Related patterns. The Roeder clamp has similar penetrating geometry. Lorna and Edna are the usual nonperforating alternatives.
Uses in Reconstructive Urology and Urogynecology
- Drape fixation. Drapes are secured to skin at the field margin or to each other at overlaps. Gaps between drapes matter in combined-position cases, such as abdominal plus perineal exposure for transperineal fistula repair or conversion between lithotomy and supine.
- Tubing and cables. Suction, cautery, light cords and irrigation lines can be secured to the drapes with the drape material held in the clip, keeping lines off the floor and out of the field.
- Tissue traction. A pair of strong towel clips has been described for tenting a linear burn on the trunk to facilitate debridement.[5] The clips can also approximate skin or fascial edges in emergency wound management.
Choose the Fixation for the Drape
| Instrument | Relevant distinction |
|---|---|
| Backhaus | Penetrating points; inspect the actual model's tip alignment and locking mechanism. |
| Jones | Also penetrating. The cross-action spring handle does not make its pointed tips nonperforating.[3] |
| Lorna / Edna | Nonperforating towel-clamp pattern; the Lorna model is described with blunt jaws. Avoid assuming that any clamp preserves an airtight seal or cannot damage a drape.[4] |
| Feature | Backhaus (penetrating) | Nonperforating (Edna, Lorna) |
|---|---|---|
| Tip | Sharp points pass through the drape and reach the superficial dermis | Blunt or flat jaws grip by compression |
| Grip | Mechanical interlock, strong | Friction, weaker |
| Skin marks | Paired puncture marks | None |
| Barrier | Perforates the drape | Preserves the drape |
Use nonperforating fixation or the drape's intended adhesive or securement system when appropriate. AST's published draping standard favors nonperforating clips and an intact barrier. Select the number and position of fixation points for the actual drape, exposure and movement expected; there is no universal four-to-six-clip requirement.[2]
Application and Removal
- Establish the planned field before securing the drape. Avoid puncturing fluid barriers, irrigation tubing, electrical insulation or underlying structures. Route tubing and cables through intended holders with enough slack for positioning changes.
- If penetrating fixation is deliberately selected, control both points and limit the tissue bite to the intended target. A drape-fixation clip is not a general-purpose clamp for a nerve, vessel or reconstructed urethra.
- Skin puncture marks may be visible on the face, neck or anterior chest. Consider nonperforating clamps or adhesive drape fixation near visible skin, as in cosmetic genital and gender-affirming surgery.
- Handle and pass it as a sharp. Release the lock before removal, support the material or skin, and inspect for bleeding or tearing. Account for all clips during counts and drape removal.
- Do not simply reapply a clip whose tips have contacted a nonsterile surface. Remove contaminated items from the sterile field and address affected gloves and materials according to the breach.[6]
If a drape is punctured, torn or suspected to be contaminated, restore the barrier. AORN describes covering the affected area with a new sterile drape; unnecessary removal may spread contamination. A towel or dressing alone is not an equivalent replacement barrier.[7]
Inspection and Reprocessing
Check points, alignment, hinges and lock before use. Follow the specific reusable instrument's cleaning and sterilization instructions; inspect the packaging and supplied sterility status. Disposable and reusable versions should not be treated interchangeably. Misaligned points fail to interlock, and dull tips tear the drape. Small puncture wounds and reported metal sensitivity require clinical assessment, and complication-free healing cannot be promised. In a study of metal skin clips, 18% of men and 23% of women were sensitive to nickel, and the grade of nickel allergy correlated with reactions to the clips. That study concerned skin clips, not towel clamps.[8]
References
1. World Precision Instruments. Backhaus Towel Clamp: curved, locking handle; model specifications. Accessed September 12, 2026.
2. Association of Surgical Technologists. AST Standards of Practice for Surgical Drapes. Effective April 13, 2008; published online standard accessed September 12, 2026.
3. Sklar. Jones Towel Clamp, 47-2930. Manufacturer description and specifications. Accessed September 12, 2026.
4. B. Braun / Aesculap. Lorna towel clamp BF463R: nonperforating, blunt. Accessed September 12, 2026.
5. Tadiparthi S, Azad S, James MI. A simple method for linear burn debridement. Burns. 2007;33(1):98–99. doi:10.1016/j.burns.2006.04.012
6. AORN Staff. 4 Common Sterile Technique Questions Answered. August 20, 2025.
7. AORN Staff. 4 Common Sterile Technique Questions Answered. July 27, 2022.
8. Lhotka CG, Szekeres T, Fritzer-Szekeres M, et al. Are allergic reactions to skin clips associated with delayed wound healing? Am J Surg. 1998;176(4):320–323. doi:10.1016/s0002-9610(98)00197-4