Skin Preparation of Patients for Surgery (Skin Prep) Purpose To render the surgical site as free as possible from

transient resident microgoorganism, dirt and skin oils so the incision can be made through the skin with minimal danger of infection

Prior to patients skin pren, on the OR table, a preliminary preparation to patients skin is to be done. 1. Bathe / shower 2. Hair removal a. Razor b. Electric clippers

Patients Skin Prep on the OR table When is the right time?

Set Up / Things to be used 1. Prep Cart / Tray 2. Include Urinary Catheterization as part of the procedure

BASIC SKIN PREP PROCEDURES (for clean areas) 1. Expose skin to be prepared 2. Don gloves 3. Place absorbent towel/cloth along each side of the area to act as an absorber of run off solution. This is be removed after the prep is completed 4. Scrub/paint with antiseptic agent but squeeze out excess solution. 5. Scrub/paint the skin, starting at the site of incision wih a circular motion in ever-widening circles to the periphery. Use enough pressure and friction to remove dirt and microorganisms from the skin and pores. 6. Discard the sponges after reaching the periphery 7. Repeat the scrub with a separate sponge for each round.

CONTAMINATED AREAS A. Umbilicus is considered a contaminated area in relation to the surface surrounding it because it may harbor microorganisms. 1. Solutions may be squeezed into the umbilicus to soften the detritus while the remainder of the abdomen is scrubbed. Or it may be cleansed first with separate sponges and applicators to avoid runoff of dirty solutions over cleaned skin area. 2. Then the abdominal prep begins with new sponges at the line of incision, moving with circular motion to the periphery and including the umbilicus again each round as it is approached within the area. 3. Umbilicus is thoroughly cleansed with cotton applicators as the final step of the abdominal prep B. Stoma in example colostomy, ileostomy, etc. Follow the same rule for use of sponges as for the umbilicus; come back to that area last, or use a separate sponge each round for the contaminated area only. The Opening of the stoma may be packed with a sponge while surrounding area is prepped.

AREAS PREPARED FOR GRAFTS Donor site should usually be scrub first before recipient.

Figures.

GENERAL RULE: Skin prep the most contaminated area last or use separate sponges to make it sure.

Thank You!