Skin preparation for surgical area, practical tips!

In this article we discuss Purpose and steps of skin preparation for surgery

Purpose:

Remove hair and dirt from the surgical area, clean the skin, prepare for skin disinfection during surgery, and prevent postoperative incision infection.

Specific operation methods and steps:

1. Prepare all the necessary equipment and bring them to the bedside. Check the bed number, name, diagnosis, surgical site, and evaluate and instruct the patient according to the doctor’s instructions.

2. Explain the purpose of skin preparation to the patient, obtain the patient’s cooperation and consent, and close doors and windows and use screens when necessary.

3. Assist the patient to expose the skin preparation area, put in a diaper pad, and check the skin preparation knife.

4. Wear disposable gloves, use a brush to dip soapy water and apply it to the local area to create foam. Hold the gauze in one hand to press the skin tightly. Use the other hand to shave the hair in different areas with a skin preparation knife. Then use a flashlight or sunlight to check the skin preparation effect.

5. First wipe the hair with toilet paper, then wash the skin with a towel soaked in warm water.

6. If you are preparing the abdomen, use a cotton swab dipped in turpentine to clean the navel.

7. Disinfect the skin with 75% alcohol, cover with a sterile treatment towel, and wrap with a chest and abdominal belt if necessary.

8. Keep things in order and be considerate and caring to the patients.

Skin preparation for special areas and situations

1. Bones, joints, tendons:

(1) On the first and second days before surgery, scrub the prepared skin area with a soft-bristled brush, disinfect it with 75% alcohol, and then wrap it with a sterile towel.

(2) Check again on the morning of the surgery to see if the surgical area has been shaved clean. Disinfect the area with 5% alcohol and then bandage the prepared skin area with a sterile dressing.

2. Hands or feet:

After admission, patients are instructed to soak their hands and feet in warm water for 20 minutes every day, cut their fingernails and toenails, and try to cut off softened calluses, but avoid damaging the skin. Patients undergoing foot surgery should not walk on the ground after skin preparation.

3. Brain:

Cut your hair short 3 days before surgery and wash it once a day (except in emergencies). Shave your hair 2 hours before surgery, wash your hair after shaving, and wear a cleaning cap.

4. Scrotum and penis:

After admission, the patient takes a warm water sitz bath every day, washes with soap, and prepares the skin one day before surgery.

5. Oral cavity:

Keep oral hygiene after admission and rinse mouth with compound boric acid solution before entering the operating room .

6. Children:

Generally no shaving is done, only cleaning is done.

General surgical skin preparation range

1. Brain surgery:

The entire scalp, forehead, mane and skin on the back of the neck, leaving the eyebrows intact.

2. Neck surgery:

It extends from the lower lip above to the sternal angle below and to the anterior edge of the trapezius muscle on both sides.

3. Breast Surgery:

It starts from the upper part of the clavicle, extends to the level of the umbilicus, and to the posterior axillary line on both sides, including the upper arm, shoulder and axilla on the same side.

4. Chest surgery:

From the supraclavicular fossa to the umbilicus level, the anterior and posterior chest range should exceed the midline by more than 5 cm.

5. Abdominal surgery:

It starts from the nipple line, extends to the pubic symphysis and perineum, and to the mid-axillary line on both sides; surgery in the lower abdomen and groin area should include the skin of the upper 1/3 of the thigh.

6. Kidney area surgery:

It starts from the nipple line above and ends at the pubic symphysis below, passing through the midline both front and back.

7. Perineum and anus surgery:

From the line connecting the anterior superior iliac spine to the upper 1/3 of the thigh, including the perineum, buttocks, and groin.

8. Limb Surgery:

The principle is to take the incision as the center, more than 20 cm above and below, generally the distal and proximal joints or the entire limb.

9. Precautions for skin preparation

(1) Keep warm and try to minimize exposure of the patient when preparing the skin.

(2) After skin preparation, take a full body bath or a partial bath and change clothes.

(3) The operation should be performed steadily and gently, and the skin should not be scratched to avoid infection.

(4) When shaving, hair should be shaved in the direction of hair growth.

(5) Observe the skin for papules, erythema, small boils, etc. If found, report to the doctor immediately.

(6) The skin should be kept taut during the operation and the razor should form a 45-degree angle with the skin.

(7) When scrubbing an area, do not soak clothes or bedding.

(8) During abdominal surgery, make sure to clean the navel, armpits, and perineum.