2. PURPOSE
– to render the operative site as
free as possible from transient
and resident microorganisms,
dirt, and skin oil so the incision
can be made through the skin
with a minimal danger of
infection from this source
5. MECHANICAL CLEANSING
• bathing the evening/morning before
surgery with an antimicrobial soap
• hair should be washed, especially for
cases of the head and neck
– NOTE: abnormal skin irritation, infection,
or abrasion on or near the operative site
may be a contraindication to the
performance of the surgical procedure
7. HAIR REMOVAL
• breaks in the skin permit the entry
and colonization of microorganisms,
a potential source of infection
• hair removal should take place as
close to the time of surgery as
possible, but not in the OR suite
so as to minimize environmental
contamination of the room
8. HAIR REMOVAL
• an order for hair removal should
be written in the Doctor's orders
• removal techniques include:
– shaving
– clippers
– depilatory cream
18. COMMON PREPPING
SOLUTIONS
• Iodine and iodophors
– povidone iodine - Betadine
– do not use on patients with
sensitivity to shellfish!
– may cause irritation/burn to skin if
warmed
22. PROCEDURE
• Assemble necessary equipment
• establish a sterile field
• Pour solutions
– if not premixed, scrub solutions
need to be diluted with sterile
water
– this may be done with sterile
gloves donned if the containers
are sterile also
23. PROCEDURE
• Expose the site to be prepped, making
sure that the blanket will not become
contaminated with prepping solution
• Place protective pads around the patient
to collect excess prepping solution
• Don sterile gloves
– open gloving without a gown technique
• Wet the applicator with scrub solution
25. PROCEDURE
• scrub the skin in a circular motion
• start at the incision point and work
toward the periphery
26. PROCEDURE
• Discard the sponge after reaching the
periphery and obtain a new one to continue
• Scrub for a minimum of five minutes or
according to hospital policy
• Dry the area with a sterile towel by placing
the towel and then patting the area, using
the cuff to lift the towel off the skin when
completed
27. PROCEDURE
• Apply paint solution using gauze on sponge
sticks
– working from the incision line to the periphery
29. SPECIALIZED PREP AREAS
• The umbilicus is considered contaminated
– this should be thoroughly cleaned
using separate gauzes, prior to
starting the skin scrub
30. SPECIALIZED PREP AREAS
• Stomas, skin ulcers, sinuses and open
wounds are considered contaminated
– a one inch area around the opening
is left during the prep and that area
is cleansed with the last strokes of
each sponge
31. SPECIALIZED PREP AREAS
• Areas of high microbial counts are
considered contaminated and are
prepped last with each sponge
– axilla
– groin
– hair line
32. SPECIALIZED PREP AREAS
• When prepping perineum
– the mons pubis is cleansed first
– then the labia majora
– the thighs outward
– the labia minora and vestibule
– the vagina
– the rectum
33. SPECIALIZED PREP AREAS
• Skin grafts
– separate preps must be used for
the donor and recipient sites
– the donor site is prepared first
34. SPECIALIZED PREP AREAS
• Eyes
– eyebrows are NEVER shaved!
– eyelashes may be trimmed with iris
scissors covered with vaseline jelly to
catch the lashes as they are trimmed
35. SPECIALIZED PREP AREAS
• Eyes
– the orbit is prepped with a drop of
iodine solution/saline and irrigated
with sterile saline from the nose side
to the lateral side
– lids are prepped with q-tips dipped in
solution and blotted on sterile gauze
