Skin Preparation - NCM 109 RLE

Skin Preparation

The removal of as many bacteria as possible from the patient's skin through shaving, mechanical washing and chemical disinfection.

Minimize

Although skin cannot be sterilized, skin preparation with antiseptic solutions ________ the number of microorganisms that may contaminate the surgical wound and cause infection

Epidermis

Protecting the body from the environment, particularly the sun. Preventing excessive water loss from the body. Protecting the body from infection

Dermis

Regulate temperature. Supply the epidermis with nutrient- saturated blood. Much of the body's water supply is stored within the dermis.

Meissner's corpuscles

sensitive touch receptors in the dermis

Vater-Pacinian Corpuscles

- found in deep connective tissue and in visceral organs

Subcutaneous Fat

Insulator, conserving the body's heat. Shock-absorber, protecting the inner organs. It also stores fat as an energy reserve for the body

Residential or Colonizing

This flora is considered permanent flora of the skin. It is not readily removed by mechanical friction as it is attached to the deeper layer, the dermis. It is less likely to be associated with infections.

Transient or Contaminating

This flora is also NOT normally found on the skin. Present on the superficial layers of the epidermis. Frequently associated with Surgical Site Infections as organisms are readily transferred from the hands to patients. Easily removed by soap and water or destroyed by antiseptic hand wash or an alcohol solution. I.e. E- Coli

Clipping

Remove hair by ______ not by shaving

Umbilicus

this should be thoroughly cleaned using cotton pledget and separate gauzes, prior to starting the skin scrub

Stomas, Skin Ulcers, Sinuses, and Open Wounds

a one inch area around the opening is left during the prep and at that area is cleansed with the last strokes of each sponge

Axilla, Groin, Hair Line

areas of high microbial counts are prepped last with each sponge

Skin Grafts

separate preps must be used for the donor and recipient sites. The donor site is prepared first

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 solution and bottled on sterile gauze

Chlorhexidine Alcohol

Is superior to povidone iodine for preventing surgical site infection after clean-contaminated surgery

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 patient's skin