Skin prep Flashcards
Why do a skin prep?
Although skin cannot be sterilized,
skin preparation with antiseptic solutions
minimizesthe number of microorganisms
that may contaminate the surgical wound
and cause infection.
what is skin prep?
is the removal of as many bacteria as possible from the patient’s skin through shaving, mechanical washing and chemical disinfection.
Purposes of skin prep
- Reduce the number of microorganisms in the field of operation.
- prevent infection
seven special consideration for skin prep
- To determine the area to be shaved, know the operation to be done
- the organ involved and its location, and the proposed incision.
- Practice modesty and provide privacy.
- Ask the patient’s permission in cutting the
eyelashes and hair. - Examine the area to be shaved for any signs of irritation or any abnormal conditions.
- Report this to your head nurse.
- Do not cut the patient’s skin.
the largest organ
skin
The skin is made up of the following layers
- epidermis
- dermis
- subcutaneous tissue/ fat layer
Three principle functions of the epidermis
- protecting the body from the environment, particularly the sun
- preventing excessive water loss from the body
- protecting the body from infection
seven main functions of the dermis
- regulate temperature and
- supply the epidermis with nutrient-saturated blood. Much of the body’s water supply is stored within the dermis
- The hair follicles are situated here.
- Sebaceous (oil) glands and apocrine (scent) glands.
- This layer also contains eccrine (sweat) glands.
- Blood vessels and nerves course through this layer. The nerves transmit sensations of pain, itch, and temperature.
- There are also specialized nerve cells called Meissner’s and Vater-Pacini corpuscles that transmit the sensations of touch and pressure.
specialized nerve cells in the dermis
Meissner’s and Vater-Pacini’s corpuscles that transmit the sensations of touch and pressure
three glands in the dermis
- Sebaceous (oil) glands and apocrine (scent) glands.
- This layer also contains eccrine (sweat) glands.
three functions of the subcutaneous fat layer
- insulator, conserving the body’s heat
- shock-absorber, protecting the inner
organs. - it also stores fat as an energy reserve
for the body
This flora is considered permanent flora of the skin.
Residential microorganism
It is not readily removed by mechanical friction as it is attached to the deeper layer, the dermis
Residential microorganism
It is less likely to be associated with infections.
Residential microorganism
Colonizing microorganism:_______
Residential
Contaminating microorganism:______
Transient
This flora is also NOT normally found on the skin.
Transient
Present on the superficial layers of the epidermis.
Transient
Frequently associated with Surgical Site Infections as organisms are readily transferred from the hands to patients.
Transient
Easily removed by soap and water or destroyed by antiseptic hand wash or an alcohol solution. I.e. E- Coli
Transient
Components for skin prep
- Mechanical Cleansing
- Hair Removal
- Skin Prep
When do we shave the patient?
Do not remove hair unless it will interfere with the operation.
How do we remove the hair of the patient during skin prep?
If removed, remove by clipping, not by shaving. Preferably remove immediately before the operation with electric clippers.
Remove clipped hair from the site.
How to clean the umbilicus?
this should be thoroughly cleaned using cotton pledges and separate
gauzes, prior to starting the skin scrub.
How to clean Stomas, skin ulcers, sinuses, and open wounds
a one-inch area around the opening is left during the prep, and that area is cleansed with the last strokes of each sponge
how to prep Axilla, groin, hairline
areas of high microbial counts are prepped last with each sponge
Perineum 7 strokes
- Clean the vulva using figure 7
- Perform #1 on another side
- Symphysis pubis going up to the umbilicus
- Inguinal to the thigh (proximal to distal)
- Perform #4 on another side
- One downward stroke (clitoris)
- One downward stroke (fourchette)
How to prep skin grafts
separate preps must be used for the donor and recipient sites. The donor site is prepared first.
How to prep eyes
eyebrows are NEVER shaved. Eyelashes may be trimmed with iris scissors covered with vaseline jelly to catch the lashes as they are trimmed. The orbit is prepped with a drop of iodine solution/saline and irrigated with sterile saline from the nose side to the lateral. Lids are prepped with q-tips dipped in the solution and bottled on sterile gauze.
Qualities of prep solution
– Broad-spectrum antimicrobial action
– Nontoxic/nonallergenic
– Long-acting protection
– Cumulative effect
Safety aspects to consider for skin prep
- Avoid pooling
– Chemical burn
– Fire potential - Avoid overexposure – hypothermia
- Allow for adequate drying before draping –
fire risk
principles of Aseptic Technique for skin prep
– Clean to dirty
– Circular or up – down cleaning
– Maintain safe distance if Sterile Person is
prepping, create a sterile field
– Discard used sponge after each application and use
– Do not move back over the prepped area
skin assessment for skin prep
- Allergies * Rashes * Warts
* Sores * Wounds
*Document findings pre and post-operatively
what is surgical draping
- Block transfer of bacteria from the patient’s skin to the surgical wound
- Must be impermeable
- Must provide effective fluid control
- Must provide comfort layer to patients skin
- Good draping qualities
– Flexible
– Sit flush to patients skin - Lint-free
Chemical solution for skin prep
7.5% betadine cleanser and 10% betadine antibacterial solution
position for skin prep
dorsal recumbent
is it advisable to do skin prep 1-2 inches from the probable line of incision
NO
All surgical skin preparation should always be in a circular motion, from cleanest to dirtiest areas
FALSE
