Proper Pre-Op Skin Preparation

In clinical settings, hair reduction, pre-operative skin preparation, and antiseptic cleansing go hand in hand, forming an essential part of evidence-based practices being followed in nursing homes and hospitals. Irrespective of the fact that there are new technologies being introduced in medical science every now and then, pre-operative skin preparation remains imperative as it prevents the infection of the surgical site. 

Why is Pre-Operative skin preparation important? The main objective of preoperative skin preparation is to mark the beginning of the antisepsis cleansing required before surgery. After any surgery, there is a high risk of surgical getting affected with postoperative surgical site infections (SSI’s). However, with proper cleansing or bathing of the skin done in CGH based compounds in the recommended ratio, this risk can be mitigated. Usually, the skin cleansing is only performed an hour or two before the surgery. However, according to the latest guidelines, cleansing the surgical site and skin with soap a night before can also help in initiating the antisepsis. Whether it is soaps or simple antimicrobial compounds used for the cleansing, pre-surgical cleaning and skin preparation always reduces the number of resident bacteria on the skin and thus mitigates the chances of serious infections significantly. 

Instructing the Patient  Majority of the times, the nursing staff are only capable to supervise the bathing or cleansing action and are not able to do it all by themselves. Thus, it becomes extremely important for the staff members to instruct the patients so that they can follow the procedure precisely and correctly. Prior to the surgery, the patient is provided with the necessary cleansing solution and clean disinfected towels along with clothing. Some of the common precautions that need to be followed include:

  1. Not putting any cream or lotion on the surgical site.
  2. Not using any chemical-based soap or washing solution.
  3. Reducing or removal of hair on or around the surgical site.
What nursing staff should do? When it comes to pre-operative skin care or preparation, hygiene is everything. Hair reduction/removal is a part of the preoperative preparation. The process is aimed at eliminating obstructions that might impede view or cause interference in the surgery. Using sterilized cotton and disinfected clothing should also be at the top of the priority list for avoiding contamination and hospital-acquired infections (HAI’s). Here are a few things that nursing staff should always do when supervising or conducting pre-op skin preparation -
  1. Educate the patient and their relatives on the importance of such preparation and seek whatever help necessary from them.
  2. Follow the guidelines as provided by the hospital/medical association for proper disinfection and sterilization of any tool that might be used in skin preparation.
  3. Supervise or perform hair removal/reduction for the ease of surgical procedure to be conducted.
  4. Clean the skin/bathe the patient or supervise the same in recommended antimicrobial solution and ensure the necessary precautions are followed to avoid any future contamination of the surgical wound.
Pre-operative skin preparation is often overlooked and its importance undermined. However, it is advised that due attention be given to the procedure for the best possible care and health of the patient.