Towel Clamp Forceps: Backhaus vs Jones vs Roeder Compared

The drape is positioned, the corners overlap at the incision site, and the scrub tech reaches for a clamp. On a linen-draped abdominal field, a sharp Backhaus bites through cloth and skin edge and locks with a confident click. Three feet away, on a patient draped in disposable nonwoven, that same sharp tip would tear a ragged hole and break the sterile barrier. The choice between a penetrating and a non-penetrating clamp is decided in that half-second, and getting it wrong costs you a re-drape mid-case.

That single decision is why a tray rarely carries one style of towel clamp. It carries a family of them.

At Fizza Surgical we forge all four patterns below in Sialkot, and the differences are not cosmetic. They change how the instrument grips, what it grips, and whether your drape survives the case. Here is how Backhaus, Jones, Roeder, and the non-perforating Lorna/Peers patterns compare before we open each one up.

What a towel clamp actually does on the field

A towel clamp, or towel forceps, holds surgical drapes and towels in position so the sterile field stays fixed while the team works. The classic job is anchoring the four towels that frame an incision so they do not slide as the surgeon leans in or as retractors put tension on the cloth.

But the work does not stop at draping. Penetrating clamps double as light tissue graspers, hold the edge of a skin flap, secure suction lines and electrosurgical cords to the drape so cables do not pull off the field, and in orthopaedic and veterinary work they can hold or reduce small bone fragments. Non-penetrating versions are restricted to surface gripping, which is exactly the point.

The instrument is simple. The decisions around it are not.

Backhaus: the reference standard

The Backhaus is the clamp most people picture when they hear “towel clip.” Two pointed jaws curve inward so that, as the ratchet closes, the tips meet and drive through the drape and into the superficial skin or the underlying towel. That inward curvature is what gives it holding power: the tips do not just pinch, they hook.

The lock is a ball-and-socket ratchet seated in the ring handle. The teeth engage in steps, so you can set a light grip on a single towel or close fully for a firm bite on linen plus skin. Once locked it stays locked until the surgeon deliberately releases it, even if the cable hanging off it is under tension.

We supply Backhaus in the two sizes that cover almost every case: the 9 cm (3.5″) for fine and pediatric draping where a lighter clamp sits closer to the field, and the 13 cm (5.25″) for general and abdominal draping where reach and a stronger bite matter. Both come in a sharp perforating tip for cloth drapes and a blunt-tip variant where you want the holding shape of a Backhaus without the full penetration of a needle-sharp point.

If your tray is heavily Backhaus and you also stock penetrating tissue forceps, the same grasp-versus-atraumatic logic applies there too. We cover that trade-off in detail in our Babcock vs Allis tissue forceps comparison.

Jones: the lightweight cross-action clip

The Jones throws out the ring handle entirely. Instead of a ratchet you get a cross-action spring: the two shanks cross like scissors, and the spring’s natural rest position is closed. Squeeze the shanks to open the jaws, release to clamp.

That makes it fast. There is no ratchet to find and seat, no two-finger release. The scrub tech opens, places, lets go, and the spring holds the towel. It is also light and short, often offered in compact 2.25″ and small-format lengths, which is why it shows up in office procedures, ophthalmic and minor-surgery setups, and any case where a full Backhaus is more clamp than the towel needs.

The trade-off is grip force. A spring holds with a fixed pressure you cannot dial up, where a Backhaus ratchet lets you ratchet down hard. For anchoring a single light towel the Jones is ideal. For pulling tension across a heavy linen field, the ratcheted clamps win.

Roeder: penetration with a built-in stop

The Roeder looks like a Backhaus and locks like a Backhaus, but it adds one feature that changes how it behaves on the patient: ball-stops on the shanks just behind the tips. As the jaws close, those balls act as mechanical stops that limit how deeply the points can travel.

This is the answer to a real problem. A sharp Backhaus, closed hard, can drive deeper into skin than anyone intended, raising bleeding and trauma at every clamp site. The Roeder’s ball-stops cap that depth. You still get penetration to hold the drape, but the instrument cannot bury itself.

The Backhaus-Roeder pattern, which combines the classic ring-handle ratchet with these depth-limiting stops, is a common request from teams who want the security of a perforating clamp while controlling tissue trauma. We forge it in the same 5.25″ and 6″ working lengths as the standard Backhaus line.

Non-perforating Lorna and Peers clamps

Everything above pierces the drape. The Lorna (also catalogued as Edna) and Peers patterns are built to do the opposite.

Their jaws are blunt and serrated rather than pointed. The teeth interlock and grip the drape surface firmly, but they never break through it. The jaws and tips are curved while the shanks and handle are flat, so the body of the clamp lies flat against the patient instead of standing up off the field.

This matters for two reasons. First, disposable nonwoven and paper drapes are structurally weaker than linen. Any perforating clamp on a paper drape tends to tear it, and a torn drape is a broken sterile barrier. A non-perforating clamp grips paper without compromising it. Second, even on cloth drapes, a non-penetrating clamp is the skin-sparing choice: no perforation means no tissue trauma and no clamp-site bleeding.

These clamps are also the standard tool for fixing suction tubing and cautery cords to the drape, where you want a firm hold and have no reason to pierce anything. As more facilities move to single-use disposable draping systems, demand for the non-perforating pattern keeps climbing.

Materials, specifications, and the steel that holds the tip

A towel clamp lives or dies on its tip. A point that rolls over after fifty autoclave cycles is useless, so the steel grade is not a detail to skim past.

Fizza Surgical forges these clamps from surgical stainless conforming to ISO 7153-1, the standard governing metals for surgical instruments. For the working tips and jaws we use martensitic grades AISI 410 and 420: these harden under heat treatment, take a sharp point, and hold an edge through repeated reprocessing. Ring-handle bodies and components that benefit from corrosion resistance over hardness use austenitic 304 or 316. Every instrument is passivated after machining to restore the chromium-oxide layer that resists rust and pitting.

Our full range of these instruments sits in the surgical instruments catalogue, and the quality-system documentation behind them is on our certifications page.

Sterilization and ratchet maintenance

Towel clamps are reprocessed constantly, and the ratchet is where they fail first if you neglect them. A few practical points:

• Clean in the open position so the box joint and ratchet teeth are exposed. Debris trapped in a closed ratchet is the most common cause of stiff or seized clamps.
• Lubricate the box joint with instrument milk after cleaning and before autoclaving. A dry joint wears its teeth and loses the crisp ratchet engagement.
• Autoclave with the ratchet left on the first tooth, not fully closed. Sterilizing a fully locked clamp stresses the joint and can crack tips over time.
• Inspect the points every cycle. A bent or dulled tip on a perforating clamp will tear drapes instead of piercing them cleanly, which defeats the instrument.
• Check Jones spring tension periodically. A spring that no longer rests fully closed has fatigued and should be retired.

A passivated 410/420 tip treated this way holds its point through years of service.

How to choose for your facility

Match the clamp to your drapes first, then to your workflow.

If you run linen or reusable cloth drapes, the sharp Backhaus is your workhorse, with the Roeder pattern wherever you want to cap penetration depth. If you have moved to disposable nonwoven or paper draping, the non-perforating Lorna/Peers should dominate your tray, because perforating clamps will simply tear those drapes. Most facilities run a mix and stock both.

For quick, light fixation and minor-procedure rooms, keep Jones cross-action clips on hand; their speed and small profile earn their place. For anything that needs a hard, lockable bite across a tensioned field, stay with the ratcheted ring-handle clamps.

Sizing follows the same logic: 9 cm Backhaus for fine and pediatric work, 13 cm for general and abdominal cases. Beyond drapes, towel clamps and the basins, trays, and kidney dishes they share a setup with all live in our hospital holloware range, so a single OR set can be specified from one source.

Tell us your drape type and case mix and our team will spec the right combination, in the grades and finishes your reprocessing protocol demands.