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Archive August 2013 XIV, No. 8

Which Skin Prep Is Best?

What we learned from the available evidence on antiseptic preps.

Judith Garcia, MHSS, MS, BSN, RN, CNOR


povidone-iodine TRIED AND TRUE There's still a role for povidone-iodine formulations in skin prepping. In fact, for eye surgeries they're the only choice.

Every surgical nurse should understand the importance of pre-operative skin antisepsis and adhering to the clinical guidelines governing its practice. Properly prepping the skin around the surgical site should be a top priority for OR staff, especially since it's a relatively inexpensive and easy-to-implement infection prevention effort. But, out of all of the products a facility may have on hand, which skin prep agent works the best? Consumed by that question, my nursing colleagues and I hit the books. Here's what we found out.

Questions of quality
We were certain that we weren't the only ones questioning the effectiveness of different skin prep solutions. It's well known that the leading infection prevention authorities, including the Centers for Disease Control and Prevention, the Association of periOperative Registered Nurses and the Association for Professionals in Infection Control and Epidemiology, haven't seen a sufficient range of clinical studies (or antiseptic products) to tip their scales toward a definitive recommendation.

Still, it's an important question to ask. As healthcare providers, we're driven to optimize patient outcomes by keeping hospital-acquired infections, and particularly surgical site infections, as low as possible. As businesses, we're always thinking about the bottom line and the benefits to be gained by cost-effective standardization. As nurses, it's in our nature to do the research required to ensure our practices are evidence-based.

With a go-ahead from administration, our team began searching the medical literature for evidence that would point the way. We reviewed more than a dozen published studies that focused on the specific characteristics and effects of pre-operative skin preparation agents, several of which were in common use at our center. But the results of our research weren't entirely open and shut. Here's why.

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