Skin prep

Question 1

Why do a skin prep?

Answer 1

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

Question 2

what is skin prep?

Answer 2

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

Question 3

Purposes of skin prep

Answer 3

1. Reduce the number of microorganisms in the field of operation.
2. prevent infection

Question 4

seven special consideration for skin prep

Answer 4

1. To determine the area to be shaved, know the operation to be done
2. the organ involved and its location, and the proposed incision.
3. Practice modesty and provide privacy.
4. Ask the patient’s permission in cutting the
   eyelashes and hair.
5. Examine the area to be shaved for any signs of irritation or any abnormal conditions.
6. Report this to your head nurse.
7. Do not cut the patient’s skin.

Question 5

the largest organ

Answer 5

skin

Question 6

The skin is made up of the following layers

Answer 6

1. epidermis
2. dermis
3. subcutaneous tissue/ fat layer

Question 7

Three principle functions of the epidermis

Answer 7

• protecting the body from the environment, particularly the sun
• preventing excessive water loss from the body
• protecting the body from infection

Question 8

seven main functions of the dermis

Answer 8

• 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.

Question 9

specialized nerve cells in the dermis

Answer 9

Meissner’s and Vater-Pacini’s corpuscles that transmit the sensations of touch and pressure

Question 10

three glands in the dermis

Answer 10

• Sebaceous (oil) glands and apocrine (scent) glands.
• This layer also contains eccrine (sweat) glands.

Question 11

three functions of the subcutaneous fat layer

Answer 11

• insulator, conserving the body’s heat
• shock-absorber, protecting the inner
  organs.
• it also stores fat as an energy reserve
  for the body

Question 12

This flora is considered permanent flora of the skin.

Answer 12

Residential microorganism

Question 13

It is not readily removed by mechanical friction as it is attached to the deeper layer, the dermis

Answer 13

Residential microorganism

Question 14

It is less likely to be associated with infections.

Answer 14

Residential microorganism

Question 15

Colonizing microorganism:_______

Answer 15

Residential

Question 16

Contaminating microorganism:______

Answer 16

Transient

Question 17

This flora is also NOT normally found on the skin.

Answer 17

Transient

Question 18

Present on the superficial layers of the epidermis.

Answer 18

Transient

Question 19

Frequently associated with Surgical Site Infections as organisms are readily transferred from the hands to patients.

Answer 19

Transient

Question 20

Easily removed by soap and water or destroyed by antiseptic hand wash or an alcohol solution. I.e. E- Coli

Answer 20

Transient

Question 21

Components for skin prep

Answer 21

• Mechanical Cleansing
• Hair Removal
• Skin Prep

Question 22

When do we shave the patient?

Answer 22

Do not remove hair unless it will interfere with the operation.

Question 23

How do we remove the hair of the patient during skin prep?

Answer 23

If removed, remove by clipping, not by shaving. Preferably remove immediately before the operation with electric clippers.

Remove clipped hair from the site.

Question 24

How to clean the umbilicus?

Answer 24

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

Question 25

How to clean Stomas, skin ulcers, sinuses, and open wounds

Answer 25

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

Question 26

how to prep Axilla, groin, hairline

Answer 26

areas of high microbial counts are prepped last with each sponge

Question 27

Perineum 7 strokes

Answer 27

1. Clean the vulva using figure 7 2. Perform #1 on another side 3. Symphysis pubis going up to the umbilicus 4. Inguinal to the thigh (proximal to distal) 5. Perform #4 on another side 6. One downward stroke (clitoris) 7. One downward stroke (fourchette)

Question 28

How to prep skin grafts

Answer 28

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

Question 29

How to prep eyes

Answer 29

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.

Question 30

Qualities of prep solution

Answer 30

– Broad-spectrum antimicrobial action – Nontoxic/nonallergenic – Long-acting protection – Cumulative effect

Question 31

Safety aspects to consider for skin prep

Answer 31

* Avoid pooling – Chemical burn – Fire potential * Avoid overexposure – hypothermia * Allow for adequate drying before draping – fire risk

Question 32

principles of Aseptic Technique for skin prep

Answer 32

– 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

Question 33

skin assessment for skin prep

Answer 33

* Allergies * Rashes * Warts * Sores * Wounds *Document findings pre and post-operatively

Question 34

what is surgical draping

Answer 34

* 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

Question 35

Chemical solution for skin prep

Answer 35

7.5% betadine cleanser and 10% betadine antibacterial solution

Question 36

position for skin prep

Answer 36

dorsal recumbent

Question 37

is it advisable to do skin prep 1-2 inches from the probable line of incision

Answer 37

NO

Question 38

All surgical skin preparation should always be in a circular motion, from cleanest to dirtiest areas

Answer 38

FALSE