02.06 Surgical Prep

Hi guys!  Today I’m going to talk to you a little bit about surgical preps.So what is the purpose of the surgical prep?  The surgical prep reduces microbials or organisms that can be on the surgical patient’s skin. Reducing these organisms can decrease the chance of them entering into the surgical site and decreases the risk of surgical site infections, which is a huge concern for our surgical patients!So I’m going to dig a bit deeper into the different surgical prep methods that exist, but I just wanted to give you a quick glance at the most common methods of surgical preps first.  These include preoperative bathing, hair removal guidelines, and cleaning the surgical site with a prep or antiseptic.

Ok let's look a little closer at preoperative bathing.  Guys it’s exactly as it sounds, the patient takes a shower or bath the night before or day of surgery with a specific type of soap or antispetic to reduce the bacteria on the skin.  A very common preoperative bathing antiseptic is known as chlorhexidine gluconate. The patient can bathe with this or it even comes in cleansing wipes. Now guys I just want to make sure I am giving you all of the information here...I want you to know that current evidence does not necessarily suggest that preoperative bathing decreases surgical site infections but it does reduce bacteria on the skin.  In spite of the evidence the CDC recommends having the patient bathe with an antiseptic preoperatively because their thought is the “benefits outweigh the harm.” Not all facilities do this so make sure you are aware of the policy at your facility.

So another surgical prep method and the most important is the prepping of the surgical site with an approved antiseptic.  This happens immediately prior to the initial incision in the operating room. The surgical site is prepped at and around where the surgeon will be operating.  There is a technique to prepping the surgical site and I will talk a little more about that on an upcoming slide.

Ok guys so there are many different types of antiseptics or “preps” that are utilized to clean the surgical site.  The type is picked by the surgeon which is based on a few different things including the ability of the prep to decrease microbials quickly, fast and easy application, and if there are any contraindications to the patient like an allergy.

Guys with all antiseptics definitely follow the manufacturers guidelines to ensure the prep is working to its expected potential!  A lot of these antiseptic preps have specific drying times so make sure you follow these. Some examples of antiseptics are chlorhexidine gluconate, povidone iodine, iodine topical solution, and combinations of these.  Often times they come in a prepared stick that has a tint to it so the person doing the prepping can see the area that has been cleaned.