What should be considered when preparing the patients skin for a surgical procedure?
DetailsMany methods are used to prepare skin for aseptic surgical procedures. The Agricultural Animal Care and Use Program at the University of Illinois Urbana-Champaign recommends the following method, based on published research results for agricultural animals and input from board-certified veterinary surgeons working with agricultural animals. Show
Step 1: Hair Removal
Step 2: Preliminary Skin PreparationNote: If the area is grossly contaminated with organic debris, use soap and tap water to remove prior to performing the preliminary skin preparation. Goal = remove gross debris and transient skin flora
Step 4: Final Skin PreparationGoal = (1) substantially reduce resident skin flora to prevent infection and (2) achieve the residual antiseptic activity. It is not possible to completely sterilize the skin. Note: The final skin preparation should be performed in the surgical suite
Antiseptic Soaps and SolutionsThe most common antiseptic soaps and solutions used for surgical preparation of agricultural animals are povidone-iodine (Betadyne), chlorhexidine gluconate (Nolvasan), and 70% isopropyl alcohol. The advantages and disadvantages of each are summarized in the table below. (From Am J Infect Control, Volume 27, Number 2, 1999.) AACUP recommends the use of Nolvasan scrub in combination with alcohol for skin preparation. Nolvasan has a substantial residual effect, is more effective in the face of organic debris (preliminary skin preparation), and was shown to reduce bacterial numbers on bovine skin significantly better than povidone-iodine. It is also less likely to cause skin irritation. Alcohol has no residual effect but effectively removes fat and soap from the skin. Phisohex (hexachlorophene) must be avoided because of neurotoxicity potential. Note: antiseptic soaps and solutions must be kept in covered containers to avoid contamination. Certain bacteria and fungi can survive in these products. Mechanism and Spectrum of Activity of Antiseptic Agents Commonly Used for Preoperative Skin Preparation and Surgical Scrubs
Abbreviations: E, excellent; F, fair; G, good; Mtb, Mytobacterium tuberculosis; P, poor; PCMX, para-chloro-meta-xylenol; SP, skin preparation; SS, surgical scrubs; U, unknown. Approved Date03/06/2021 Revised Date03/06/2021 Standard What should be considered when preparing the patient's skin for a surgical procedure?Preoperative/Preadmission Skin Preparation:
On the day of surgery, gently wipe the skin with either an alcohol or chlorhexidine based solution (i.e. 70% isopropyl alcohol, chlorhexidine gluconate) in the preoperative area or in the operating room to provide a preliminary cleanse of the entire surgical field.
What is preparing for skin before surgery?The most common skin preparation agents used today include products containing iodophors or chlorhexidine gluconate. Agents are further classified by whether they are aqueous-based or alcohol-based solutions.
Why is surgical site preparation important?Surgical skin preparation is performed in order to reduce bacterial load at the surgical site. The most widely used agents are chlorhexidine gluconate (CHG) and iodophors (i.e. povidone-iodine (PVP)) in alcohol based solutions [24].
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