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tices. Let's look at the strength and quality of each
piece of evidence, along with how they relate to bed-
side practices, based on new prepping guidelines
AORN is scheduled to release in July.
Pre-op showering
The evidence is strong that pre-operative bathing or
showering is an effective way to reduce skin flora
and that the benefits outweigh the harms (such as
possible skin irritation or allergic reactions).
Although it's intuitive to suggest that reducing tran-
sient and resident microorganisms on the skin
reduces the risk that a patient will develop an SSI,
there's not enough research to say that for certain.
Nor is there enough strong evidence to say that
any one antiseptic is more effective than another for
preventing SSIs. We do know that alcohol-based
antiseptics may be more effective than those that
are water-based, but other than that, the evidence
doesn't clearly favor one over another. In fact, a
Cochrane review of 13 randomized control trials
concluded that the evidence for skin antiseptics is
lacking quality, and that no conclusion could be
reached as to which is the most effective skin anti-
septic. That's not to say that it's impossible that one is more effective than
another, but it's an unresolved issue that warrants further research.
As for the ideal number of pre-operative baths or showers, here, too, the
evidence is lacking. Until more evidence becomes available, AORN will con-
tinue to recommend that patients be instructed to bathe or shower with
either soap or a skin antiseptic on the night before or day of surgery. The
bulk of available evidence suggests that using 2% chlorhexidine-impregnated
S K I N P R E P P I N G
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