Preoperative patient preparation

Pre-op washing: 

Using soap to physically remove dirt and remove transient microorganisms from the surface of the skin.

A regular soap is enough for cleaning, patient is not required to use costly antiseptic soaps.

Pre-op hair removal: Hair should be clipped not shaved

INTRA-OP SKIN DISINFECTION:

SCRUB AND PAINT

Things to keep in mind while cleaning:

• Clean the areas in a circular motion going outside from the center

• Always prep from "clean to dirty" areas, starting with the incision site

• Pour the antiseptic on the gauze

• After contact with peripheral or contaminated areas of the prep site, discard the sponge/applicator and use new sponge/gauze to clean new sites (e.g. cleaning the umbilicus, inside the vagina)

• Do not "back track" over an area that has already been prepped with the same prep sponge/gauze

• Prepped area should extend to an area large enough to accommodate:

1) The potential extension of the incision 

2) The potential for additional incisions 

3) All potential drain sites

 

 

DRAPING:

The purpose of draping is to eliminate the passage of microorganisms between nonsterile and sterile areas.

(1) Handle the drapes as little as possible

(2) Hold the drapes high enough to avoid touching nonsterile area but avoid touching the overhead light

(3) Hold the drape high until it is directly over the proper area, then drop (open fingers and release sheet) it down where it is to remain. NEVER ADJUST ANY DRAPE. If the drape is incorrectly placed, leave it in place and place another drape over it

(4) Do not let the gloved hand touch the skin of the patient

(5) If a hole is found in a drape after it is laid down, cover the hole with another drape or discard the entire drape

(6) If the end of a drape falls below waist level,or gets contaminated,do not handle it further. Drop it and use another drape. If in doubt about sterility, discard the drape

Written by our guest author Swapnil Bhagat

Illustrations by Anveshi Nayan
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