Lithotomy Leggings and Drapes Explained: Fit, Fabric and Specification

Lithotomy leggings are tube-shaped drapes that slide over a patient's legs, and usually over the stirrups too, when the patient is positioned on their back with hips and knees flexed and the legs supported apart. They cover the legs so the team works around a clean draped field at the perineum. In reusable form they are woven cotton or poly-cotton sleeves, closed at the foot end, sized to the stirrups and leg supports your theatres actually use.

This guide explains what leggings do, how they fit into a lithotomy drape set, and what to put in the specification if you are ordering reusable ones.

What the lithotomy position asks of the drapes

In the lithotomy position the patient lies supine with the legs raised in stirrups or leg holders. It is used for many gynaecological, urological, colorectal and perineal procedures, as well as some obstetric work. The operative site sits at the end of the table, between the legs, and that creates three draping problems that a flat sheet cannot solve on its own:

• The legs are raised and apart, so a flat drape either slips off or bunches.
• The stirrups and leg holders are part of the field's surroundings and need covering.
• The surgeon often sits or stands directly between the legs, so the drapes must stay put while people move close to them.

Leggings handle the first two problems. Other pieces in the set, such as an under-buttock drape and an abdominal or perineal drape, handle the rest. Your theatre team decides the exact combination per procedure; the textile supplier's job is to make each piece to the size and shape they specify.

What a lithotomy legging looks like

A legging is essentially a long, wide sleeve with one closed end. The open end is at the top of the thigh, and the closed end goes over the foot and the stirrup boot or leg support. Common features include:

Shape and closure

• Closed foot end so the leg and stirrup are covered fully.
• Wide opening at the top so the drape can be pulled on without contaminating the outer surface. Teams usually fold a cuff at the opening so the gloved hands stay protected while the legging is applied.
• Tapered or straight body. A straight tube is simpler to make and fold; a tapered one sits more neatly on slim leg holders.

Length

The legging must reach from upper thigh to beyond the foot, with enough extra to cover the stirrup. Candy-cane stirrups, boot-type holders and knee-crutch supports have quite different profiles, so length and width should be measured against the equipment in your rooms, not taken from a generic size.

Pairing and marking

Leggings are used in pairs, and a pair should stay together through laundry and packing. Marking each piece with a set code or "L/R" is usually unnecessary because most are symmetrical, but marking with the facility name and item code helps the laundry return them to the right pack. A woven or printed label near the opening is easy for laundry staff to find.

Leggings within a lithotomy drape set

Most theatres do not use leggings alone. A typical reusable lithotomy set might include the following, though the content of your pack is set by your theatre and CSSD teams:

Piece	Purpose	Notes for specification
Leggings (pair)	Cover legs and stirrups	Length and width to suit your leg holders
Under-buttock drape	Placed under the patient's buttocks, hanging over the table end	Size to table width and drop; some include a pouch for fluid collection
Abdominal or perineal drape	Covers the abdomen and frames the perineum	May be fenestrated; fenestration drawn to procedure
Instrument trolley cover	Covers the back table	Sized to the back table
Hand towels	For drying hands after scrubbing	Usually packed on top

Some teams prefer a single integrated lithotomy drape with built-in leggings rather than separate pieces. That design reduces the number of items to fold but is bulkier, takes longer to inspect, and is harder to reuse if one section is damaged. With separate leggings, a worn legging can be withdrawn and replaced without scrapping the whole drape. If you are weighing those options, the overview in types of surgical drapes is a useful starting point, and split and U drapes covers another way of draping around legs and limbs.

How to measure for reusable leggings

Generic sizes are a common reason for leggings that are too short to cover the stirrup or so wide they slide down mid-procedure. A short measuring exercise in each theatre avoids that.

1. List the leg holders in use. Note each model across all theatres, including any day-surgery rooms, because different rooms often have different equipment.
2. Position a volunteer or mannequin in the holders with a typical setting, or ask a theatre nurse to set the stirrups to their usual height.
3. Measure the length from the top of the thigh to just beyond the furthest point of the stirrup or boot.
4. Measure the widest girth you need to pass over, which is usually the boot or the stirrup bar with the leg in it, and add room to pull the legging on easily.
5. Agree the cuff: how deep it should be and whether it needs a marked edge so staff know where to hold it.
6. Draw it up. A simple dimensioned sketch with length, opening width, foot-end width and cuff depth is enough for a supplier to cut a sample.
7. Test the sample on the real equipment before approving bulk. OT linen sample approval sets out how to run that trial.

If your rooms use more than one type of leg holder, you may need two legging sizes. Mark them clearly so packs are assembled with the right size for each room.

Fabric and construction points

Reusable leggings go through the same laundering, inspection and sterilisation cycle as the rest of the theatre linen, so the fabric choice follows the same logic as your drapes.

• Woven cotton or poly-cotton. Cotton is soft and absorbent; poly-cotton tends to hold its shape and resist shrinkage better through repeated hot washes. Ask the supplier which they recommend for your laundry process.
• Colour. Most theatres keep leggings in the same green or blue as the rest of the drapes. Some use a different shade so leggings are easy to spot during folding. Whatever you choose, keep it consistent across packs.
• Seams. Flat, well-finished seams last longer and shed less. Check the closed foot end in particular, as it takes strain when pulled over the boot.
• Barrier performance. Woven reusable leggings are theatre textiles. If your procedures require a drape with a defined liquid barrier performance, ask the supplier exactly what the fabric has been tested to and request the documentation. Your infection-control and theatre teams decide whether a product is suitable.

Inspection and replacement

Leggings get pulled hard over equipment, so they wear in predictable places: the closed foot end, the seam along the length, and the cuff. During post-laundry inspection, look for:

• thin spots or holes at the foot end,
• seam slippage or open stitching,
• stains that do not come out,
• shrinkage that makes the legging too short to cover the stirrup.

Withdraw leggings that fail inspection and replace them as a pair if the remaining one is visibly different in colour or length. Keeping a small reserve of spare leggings makes this easy without breaking up packs. Record withdrawals so you can see which sizes wear out fastest.

Ordering checklist

• Leg holder models in each theatre, with measurements
• Legging length, opening width, foot-end width and cuff depth
• Number of sizes and how they will be distinguished
• Fabric (cotton or poly-cotton) and colour
• Marking: facility name, item code, size
• Quantity: pairs per pack, packs in circulation, spares
• Sample approval on real equipment before bulk

MISHAREN makes reusable theatre textiles to order, including drapes cut to the buyer's dimensions, at its own production unit in Konni, Kerala, with each order shipped to the UAE and delivered across the seven emirates. Shipping time is included in the lead time confirmed in the quotation.

If you would like leggings or a full lithotomy set made to your drawings, see our OT gowns and drapes page or send your measurements through contact for a quotation.