SKIN PREPARATION FOR

CAESAREAN SECTION
 SKIN PREPARATION 
the skin of the operative site and an
extensive area round the site
is mechanically cleansed again with an
antiseptic solution prior to draping.
 PURPOSES
To reduce the resident and transient microbial counts
at the surgical site immediately prior to making the
surgical incision.
To minimize rebound microbial growth during the
intraoperative and postoperative period.
To reduce the risk of post surgical site infection.
 To prevent injury to the patient during surgical skin
preparation.
 GUIDELINES
• The surgical skin prep shall be performed using an
Infection Prevention and Control Program approved
antiseptic agent. Whenever possible the
recommendation is for use of a Chlorhexidine-Alcohol
prepping solution; however factors to be considered in
the selection of a preoperative skin antiseptic agent
include:
Patient allergies
 Condition of involved area
 Number and/or types of contaminants
The characteristics of the skin to be
cleansed/disinfected
 General physical condition of the patient
The written review of the manufacturer’s information
 The surgeon’s preference
The agent should be non-irritating, non-toxic, easily
 COMPONENTS

1. Mechanical cleansing
bathing the evening/ morning before surgery with
an antimicrobial soap.
Note: abnormal skin irritation, infection or
abrasion near the operative site may be a
contraindication to the performance of the
surgical procedure.
2. HAIR REMOVAL

Breaks in the skin permit in the entry and

colonization of microorganisms, a potential source of
infection
Hair removal should take place as close to the time of
surgery as possible, but not in the OR suite so as to
minimize environmental contamination of the room.
An order for hair removal should be written in the
DR’s order
Removal technique include:
Shaving
Clippers
Depilatory cream
SKIN PREP

Mechanical cleansing
Pressure
Friction
Chemical antisepsis
Antiseptic agents shall:
 have any unused portion of opened bottles, not
containing preservative (ie. 4% alcohol) immediately
discarded after use
 be dated if containing preservative . Bottles shall be
discarded after 30 days or per manufacturer’s
recommendations
 not be warmed (unless recommended by manufacturer),
as this may alter the chemical properties and equilibrium
of the solution causing burns;
be applied by non-scrubbed personnel
be applied in a manner to prevent pooling:
- in skin creases
- under the patient
- around/below a tourniquet
-under an electrosurgical dispersive electrode
- near EKG electrodes
 not remove surgical site markings when surgical
skin prep is performed.
 COMMON PREPPING SOLUTION

1.Chlorhexidine gluconate
- hibiclense
- hibitane tincture
2. Iodine and iodophors
- povidone iodine- betadine
note: do not use on patients with sensitivity to shellfish,
may cause irritation/ burn to skin if warmed
3. Alcohol
- isopropyl 70%
note: it is flammable, do not allow to pool,
especially with ESU and laser cases.
4. Hexachlorophine
- phisohex
- phisoderm
Prior to performing the surgical skin prep:
 ensure that the antiseptic agent is compatible with the site to
be prepped
perform a preoperative skin assessment of the area to be
prepped including any areas where solution may pool
assess patient for allergy or sensitivity to antiseptic agent
 remove all body jewelry. Areas of skin that were pierced by
the jewelry and are situated in the area to be prepped shall
have the pierced site cleansed with alcohol and allowed to dry.
The following should be documented in the patient’s
health record:
condition of the skin at the operative site pre and post
operatively
method of hair removal, if used
 name and concentration of antiseptic agent(s) used
any skin reaction that occurred
 name of person performing the skin preparation