Fold the drape in half on either side, to prevent it from slipping off. Drape above and below, enough to get suction, etc. Stitch the drapes onto the skin in four corners with silk, or clips.
Time-out.
Remove skin stitches. Take a pus swab for MC+S from the mediastinum.
Lift the sternal edges away from the mediastinum and go into the pleura.
Clear away clots with suction and forceps.
Take drains out and fold them. Remove any swabs.
Avoid touching the myocardium with metal as it can be irritable. Open the retractor a bit before placing it on the patient. Use the sucker to retract against the diaphragm rather than the myocardium.
Washout. Clear the drains fully.
Place the drains back.
Goretex in interrupted sutures. May be easier to cut it to size, place the top and bottom sutures. 3 on the left, 2 on the right, covering the innominate vein.
Swab in for closure. Wires. Check wire holes. Close in layers as usual.