AORN offers advice on single/double wrapping

[Editor’s note: To help our readers, Same-Day Surgery is printing advice in the top 10 areas that receive the most questions at the Center for Nursing Practice, Research, and Health Policy at the Association of Operating Room Nurses (AORN) in Denver. The sixth topic, addressed in this month’s issue, focuses on single/double wrapping. The product mentioned in the second paragraph is Kimguard One-Step Sterile-Wrap from Roswell, GA-based Kimberly-Clark.]

AORN’s current recommended practices for selection and use of packaging systems state, "Packages should be sequentially double wrapped when using woven and nonwoven packaging materials." These recommended practices are intended as achievable recommendations representing what is believed to be an optimal level of practice. Policies and procedures will reflect variations in practice settings and/or clinical situations that determine the degree to which the recommended practices can be fulfilled.

In 1995, AORN became aware of a new, nonwoven product that allows double wrapping to be accomplished in one step, but not sequential double wrapping, because the product’s edges are bound together. The new product also allows for one-step opening.

Because the Center for Nursing Practice, Research, and Health Policy received several calls regarding this product, the AORN Recommended Practices Coordinating Committee requested that the "Recommended Practices for Selection and Use of Packaging Systems" be reviewed. The approved recommended practices include new information with respect to this subject.1 Information regarding the practice of sequential double wrapping has been changed, due to lack of scientific support. We recommend that you obtain documentation from the manufacturer of the single wrap you are considering, outlining the parameters of the wrap in terms of its ability to provide a tortuous bacterial pathway, as well as an aseptic presentation. Based on the information you receive, it becomes your prerogative to establish your policies.

Remember, the final version of the recommended practice, approved by the AORN board of directors, provides the necessary criteria for you to evaluate your current practices.


1. Association of Operating Room Nurses. "Recommended Practices for Selection and Use of Packaging Systems." In: AORN Standards and Recommended Practices. Denver; 1996, pp. 221-226.

[Reprinted with permission from AORN Online (, 1997. AORN Inc., 2170 S. Parker Road, Suite 300, Denver, CO 80231.]