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I N F E C T I O N
P R E V E N T I O N
As evidenced by the Darouiche study, the iodine-and-alcohol
combination might not be used as widely or as frequently as other
prepping solutions, but Ms. Felizardo suggests that the time may
be right for a re-evaluation, noting that its effects are similar to
those of CHG-and-alcohol products, and particularly practical for
abdominal surgery.
4
Preps must always be
applied in a circular pattern.
False. Just as different skin-prepping agents are intended for different parts of the anatomy and have different antimicrobial
effects, they also have different application techniques.
A circular application, starting at the incision site and spiraling
outward, has traditionally been recommended for a povidoneiodine paint. But CHG formulations benefit from a back-and-forth
scrub over the site, starting at the least contaminated area and
moving to the most contaminated. "Friction is what does it," says
Ms. Hanus.
One iodine-alcohol product, on the other hand, recommends a
single-stroke motion to cover the site, not a back-and-forth one,
before letting the solution dry completely. "Application is basically the biggest mishap in skin prepping," says Nicholas Wade, RN,
MPH, the director of infection prevention at Forest Hills (N.Y.)
Hospital. "People don't apply the product for the correct amount
of time for it to be effective." And, adds Ms. Felizardo, "if your
staff isn't educated on the requirements for each type of prep,
they may default to a circular motion, which is not effective for
some of them."
In the clinical environment, "education must be part of anything
you're doing," says Ms. Hanus, who recommends in-servicing staff
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
