Home E-Weekly December 19, 2017

Should Arms Be Covered During Skin Prepping?

Published: December 18, 2017

GO LONG Wearing long-sleeved jackets or scrub tops while prepping a patient could help decrease airborne contaminants.

Prepping the skin while wearing long sleeves with gloves could decrease airborne contaminants by up to 50%, suggests a new study in the American Journal of Infection Control.

AORN and OSHA guidelines "advise non-scrubbed personnel to wear long sleeves in the OR to prevent skin shedding because infection can result if the arms are not covered," but the use of long sleeves by nonscrubbed personnel in the operating room has long been debated.

Researchers conducted mock patient skin preps in 3 different ORs and used particle counters to observe the level of airborne particulate contamination. Bacterial contamination was cut in half in 2 of the rooms tested, specifically reducing the shed of the bacteria Micrococcus. The third room saw no difference, but researchers attribute that to the third OR being "dirtier" than the other 2 ORs. "That OR had exponentially higher bacterial and particle counts compared to the others," he says.

"Wearing long sleeves and gloves likely prevents skin shedding with the back-and-forth motion that we do to apply the skin prep directly over the patient," says study author Troy Markel, MD, an assistant professor of surgery at the Indiana University School of Medicine. "Since bacteria travel on skin cells, it is possible that this could be a nidus for wound infection."

Although further studies with real patients still need to be conducted in order for his findings to support policy change, Dr. Markel says this study is a piece of data that could be added to the puzzle when determining OR attire. In order to prevent contamination, Dr. Markel also recommends paying attention to environmental factors like ventilation systems, surfaces, temperature and humidity, all of which can play a role.

"Other things people can do is ensure that they wear clean scrubs and hats, clean shoes dedicated to the OR and practice general sterile techniques," he says. Even though it might not be necessary for all OR staff to wear long sleeves, this study shows that it could prove a beneficial change for those tasked with prepping patients.

Brielle Gregory

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