Term
| what is the purpose of skin prep? |
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Definition
| To render the surgical site as free from transient and resident microorganisms, dirt, skin oil so that an incision can be made with minimal infection from the skin source |
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Term
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Definition
Hair should be removed by the use of clippers or depilatory cream
Razors are not recommended
Hair may interfere with the exposure, closure or dressing
Prevent adequate skin contact with the grounding pad or ECG pads
Patient may be shaved in the OR after the administration of the anesthetic
Care needs to be taken remove all hair from the field
A wide piece of adhesive tape can be used to collect the hair |
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Term
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Definition
Clipping can be done using short strokes against the direction of hair growth
Short stubble does not interfere with skin antisepsis or exposure of the site
After use the disposable head is removed and discarded
The handle wiped off with a disenfectant
Disposable clipper heads are preferred over reusable styles
For function and sharpness |
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Term
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Definition
Removal of hair through the use of chemical depilation before the patient comes to the OR suite
A preliminary skin patch test should be done on a forearm before the application
Should not be used around the eyes or genitalia
After the product has been on for about 20 minutes, it is washed off and hair comes off with the cream
Any irritation should be documented |
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Term
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Definition
Shaving should be done as near to the time of incision as possible
Avoid making nicks and cuts in the skin
Gloves should be worn
Time lapse between the shave and the procedure may increase the risk of post-operative infection
Wet shaving is preferred to dry
Leaves the skin abraded |
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Term
| what does skin surface contain |
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Definition
Prespiration
Oils
Dead skin cells |
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Term
| name 2 effective fat solvents |
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Definition
| Isopropyl Alcohol or acetone |
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Term
| list preping areas that are considered contaminated: |
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Definition
Umbilicus
Stoma
Other Contaminated Areas
Foreign Substances
Traumatic Wounds |
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Term
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Definition
Umbilicus
Cleaned with cotton tipped applicators before main prep
Prevents debris from the umbilicus from splashing on the freshly prepped site |
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Term
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Definition
Stoma
Intestinal stomas are contaminated with fecal material and intestinal flora
Stoma should be isolated and prepped last
If the stoma is to be incorporated with the surgical incision it is prepped and dried last and covered by a sterile clear plastic drape to prevent contamination of the wound
Packed with a betadine soaked radiopaque sponge
Sponge needs to be accounted for at the end of case |
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Term
| what is the point of cleaning a truamtic wound and how do you do it? |
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Definition
| clean with warm saline to remove debris |
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Term
| Areas Prepared for Grafts set up |
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Definition
Separate setups are necessary for skin preparation of recipient and donor site
Donor site should be scrubbed with a colorless antispetic solution so that the surgeon can properly evaluate the vascularity of the graft postoperatively
Items used in the preparation of the recipient site must not be permitted to contaminate the donor site |
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Term
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Definition
Discovered in England in 1950
2% -4% solution is used as a skin cleansing soap preoperatively
Broad spectrum
Rapid acting
Binds to microorganisms to produce irreversible damage or death
Has minimal activity against yeasts, spores, and TB
Effect against most viruses
Not absorbed through intact skin but binds with mucous membranes
Contraindicated for facial preps |
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Term
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Definition
Discovered in 1812
First used in wound care in 1839
Solution of 1% or 2% Iodine in water or in 70% alcohol is an excellent antiseptic
Iodophors are iodine compounds that may be combined with detergents
Betadine is a commonly used detergent form of iodophor
Excellent cleanising agents remove debris from skin while slowly releasing iodine
Iodine and Iodophors
Broad spectrum antimicrobial agents that have some virucidal and sporicidal activity
Relatively nontoxic
Virtually nonirritating to skin or mucous membrane
Brown film left on skin clearly defines area of application
Not used to prep patients who are sensitive or allergic to iodine or seafood |
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Term
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Definition
Isopropyl and ethyl are broad spectrum agents that denude proteins in cells
70% concentration with continuous contact for several minutes is satisfactory for skin antisepsis
Not applied to mucous membranes or used in open wounds
Must not pool around or under the patient
Vapors can accumulate under the drapes and become an explosion hazard |
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Term
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Definition
Solution of 0.25% to 3% triclosan is a broad spectrum antimicrobial agent
Considered not toxic and safe for use on the face
Do not allow solution to enter the eyes |
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Term
| Parachlorometaxylenol (PCMX) |
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Definition
Developed in Europe in 1948 as a hair conditioner
Has bacterial properties useful for skin antisepsis
Effective against some fungi, TB and viruses
Nontoxic to skin , eyes and ears |
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Term
| head neck and eye preping |
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Definition
Eye brows are never shaved or removed
Do not grow back completely or evenly
Eye lashes may be trimmed
Eye lids and periorbital
areas are cleansed with a nonirritating antiseptic agent then rinsed with warm sterile water
Prep starts centrally and extends to the periphery
From the center of the lid to the brow and cheek
Conjunctival sac is flushed with a nontoxic agent such as normal saline
Head is turned slightly to the affected side
Take care to prevent prep solution to enter eyes or ears |
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Term
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Definition
Lateral Thoracoabdominal area
Arm is held up during the prep
Beginning at the site of incision, area may include the axilla, chest and abdomen from the neck to the iliac chest
For surgery in the region of the kidney it extends up to the axilla and down to the pubis
Also extends beyond the midlines anteriorly and posteriorly and may include the arm to the elbow |
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Term
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Definition
Anesthesia turns patients face toward unaffected side
Arm on the affected side is held up by grasping the hand and raising the shoulder and axilla slightly from the bed
Prep area includes the shoulder, upper arm down to the axilla and chest wall to the table line and beyond the sternum to the opposite shoulder |
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Term
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Definition
Shoulder
Anesthesia turns the patient’s face toward the opposite side
Arm is held up by grasping the hand and elevating the shoulder slightly from the bed
Prep area includes the circumference of the upper arm to below the elbow, from the base of the neck over the shoulder, scapula and chest to the midline |
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Term
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Definition
Rectoperineal
Patient is in lithotomy
Prep area includes the pubis, external genitalia, perineum, anus and inner aspects of the thigh
Begin scrub over the pubic area, scrubbing downward over the genitalia and perineum
Discard the sponge
Inner aspects of the upper third of both thighs are scrubbed with separate sponges working from the groin to distal aspect of the thigh
Anus is prepped last
Rectoperineal is prepped before the abdomen using a separate prep set and gloves if an abdominal approach is planned |
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Term
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Definition
Arm is held up by grasping the hand and elevating the shoulder slightly from the bed
Prep area includes the entire circumference of the arm to the wrist, the axilla, and over the shoulder and scapula |
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Term
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Definition
Arm is held up by grasping the hand
Prep area includes the entire arm from the shoulder and axilla to and including the hand |
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Term
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Definition
Hand
Arm must be held up by a gloved person supporting it above the elbow so that the entire circumference can be scrubbed
Prep area includes the hand, and arm to 3 inches above the elbow
Be sure to scrub the fingers and in between |
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Term
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Definition
Hip
Leg on affected side is held up by supporting it just below the knee
Prep area includes the abdomen on the affected side, the thigh to the knee, the buttocks to the table line, the groin and the pubis |
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Term
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Definition
Thigh
Leg is held up by supporting the foot and ankle
Prep area includes the entire circumference of the thigh and leg to the ankle, over the hip and buttocks to the table line, the groin and the pubis
Take care not to have solution pool under the buttocks |
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Term
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Definition
Leg is held up by supporting the foot and ankle
Prep area includes the entire circumference of the leg and extends from the foot to the upper part of the thigh |
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Term
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Definition
Foot is held up by supporting the leg at the knee
A leg holder is useful
Prep area includes the foot and entire circumference of the lower leg to the knee
Be sure to prep between the toes |
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Term
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Definition
Patient in supine position
Prep area includes breast line to upper third of thighs from the table line right and left
Scrub
Blot
Paint |
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