Surgical Site Preparation

Guidelines:

• Hair
  • Current guidelines: leave hair unless required for visualization (skull)
  • Clippers > razors, outside OR
• Proper product selection (table on its own slide)
  • Evidence based facility policy
  • Allergies
• Dry time
• Avoid alcohol for babies
• Assess skin before/after
• Always SDS and IFU
• Prep most contamination first(GYN!)

Considerations:

• Dry time is before drapes not before cut
• Avoid pooling
• Document!
• Alcohol storage
• Preop (night before) bath when possible
• Re-drape and re-prep vs cutting drape

Nurse’s role:

• Product selection if not specified
• Circular motion, in to out clean to dirty (dirtiest of multiple SITES first)
• Assessment
• Documentation
• Logistics
• Holding limb for dry time
  • Infinite resources

Pitfalls:

• CHG in vagina
  • Mixed research, ruined flora postop
• Cutting drapes
• Assessing patient after prep
• Wrong product
• Open cuts wounds shaved

Examples:

• Eye surgery (opth iodine)
• Abdominal (anything pending allergy)
• Ear (iodine aqueous)
• Mouth (parodex, or iodine)

Linchpins (Key Points):

• Patient prep is typically a nursing responsibility and improper application can be harmful