Definition: Skin preparation is the removal of as many bacteria as possible from the patient’s skin through shaving, mechanical washing and chemical disinfection Purpose: 1. Reduce the number of microorganisms in the field of operation. 2. Prevent infection. Special Considerations:

3. 4. 5. 6. 7. 8. 9.

Ear Operation – shave 2 ½ inches around the ear. Neck Operation – anteriorly shave from the chin down to the nipple line. Laterally shave from the patient’s hairline to the sides of the neck including the shoulders and axilla. Posteriorly, shave the hairline down to the level of the clavicle. (see figure) Chest Operation – shave from the base of the neck to the waistline including the axilla and inner aspect of the arm. Posteriorly, shave from the shoulder line down to the waist extending 2 ½ beyond the spinal column. (see figure) Abdominal and Pelvic Operations – shave from the nipple line down to the symphysis pubis, vulva, perineum and the thighs 2 inches from the groin. Include the sides or flanks of the patient. (see figure) Kidney Operation – anteriorly shave from the nipple line down to the perineum from side to side posteriorly on the affected side, shave from the subscapular area down to the buttocks and 2 inches beyond the spinal column. (see figure) Vaginal, Scrotal, and Rectal Operations – shave the waistline to the perineum. Include the anterior and inner aspects of the thighs 6 inches from the groin. Posteriorly, shave the entire buttocks. Pay particular attention to the hair between the folds of the buttocks ans anus. (see figure) Lower Extremity – if the operation is in the distal portion, clean from the 2 inches above the knee, all around the extremity to the toes. If the operation is at the knee or little bit above or below it, clean the entire extremity from the groin to the toes. Pay attention to digital spaces. (see figure) the fingers all around. If the operation is at the elbow or a little above or below it, shave from the axilla to the fingers and all around the extremity. (see figure)

2. 3. 4. 5. 6. 7.

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. In abdominal operations, pay particular attention to the umbilicus. Shave the operative site the day or the night before operation. Discard soiled sponges in your kidney basin borrowed from the ward.

8. 9.

In shaving, follow the direction of the growth of hair while the free hand exerts an opposite force by pulling the skin to the opposite direction. This is done: a. to make the shaving less painful b. to shave off the hair thoroughly from the skin 10. If a wound is present on the area to be shaved, start from the clean area to the dirty area. Equipment: Shaving tray 1. 2. 3. 4. 5. with the following: Razor with blade Container with dry cherries or sponges Container with cherries in liquid soap Pick-up forceps (2) Kidney basins

10. Upper Extremity – if operation is at the distal portion, clean from 2 inches above the elbow to

Procedure: 1. Assemble all the articles and bring to the patient’s room. 2. Explain the procedure to the patient. 3. Provide privacy. 4. Place a rubber protector under the patient. 5. Expose the area to be shaved 6-8inches from the probable line of incision. 6. Using the pick-up forceps, get sponges saturated with liquid soap and make a thick lather on the skin staring from the probable line of incision going to the periphery. 7. Shave the area. 8. Clean the area with wet sponges. 9. Saturate again the skin with liquid soap and continue on shaving until the area is completely devoid of hair. 10. Dry with sponges. Areas to be Prepared:

Neck Operation

Chest Operation

1. 2.

Eye Operation – cut the eyelashes of the affected eye. This is done in operating room. Use small straight eye scissors (Steven’s). Clean with alcohol and apply Vaseline. Nasal and Sinus Operation – no shaving is done unless the patient has moustache, with hairy face or hairy nose. Abdominal and Pelvic Operations

Vaginal , Scrotal and Rectal Operation

Lower Extremity