Abdominal Perineal Surgical Skin Prep

Part 1: Perineal Prep

Perineal Prep Supplies

Plastic bag / waterproof sheet 

Gloves

Long sponge forcep ( female patient )

Prep set with povidone iodine unless contraindicated

Perineal Prep Boundaries

Mons pubis to buttocks bedline

Inner thigh across to other inner thigh

Step 1: Mons Pubis and External Genitalia

With a Povidone soaked sponge start at the top of the pubis

Side to side motion over pubis

Move downwards over external genitalia ( never going back up )

Stop prep before prepping over anus, discard sponge

Pour more prep over sponge if needed but NO double dipping from prep kit!

If the patient is male ensure foreskin is retracted, cleaned and returned to original position 

Step 2: Inner Thighs

With a Povidone soaked sponge start at inner groin of one thigh 

Moving in an up and down motion from perineum (proximal) to 1/2 way up the inner thigh (distal)

Discard sponge

Obtain a new sponge and proceed to the other thigh in the same fashion

Step 3: Vagina Prep

With a long sponge stick and a Povidone soaked sponge insert sponges directly in vagina

Move sponge stick in a circular motion ensuring all vaginal folds are prepped

Discard sponge

Repeat with a new sponge

Step 4: Second Prep of Pubis, Genitalia and Thighs

Repeat step 1 and 2

Step 5: Lower Buttocks and Anus

Take a Povidone sponge and prep buttocks touching bed from out to in 

Prep anus with one swipe and discard sponge

Part 2: The Abdominal Prep

Abdominal Prep Supplies

- Tape over electrodes

- Gloves ( personal protective wear )

- Cotton Swab ( umbilicus )

- Prep set with chlorhexidine prep unless contraindicated

Abdominal Prep Boundaries

- Bedline to bedline

- Xyphoid process to mons pubis / outer legs

Step 1:  Umbilicus

Using a chlorhexidine dipped cotton swab clean umbilicus of any lint or debris.  Source of surgical contamination 

Use several if needed

Step 2:  Abdomen

-Starting at the belly button clean in concentric circles 

-Clean upper thigh and up to bedline on your side

Obtain a new sponges, walk over to other side of patient and clean upper thigh and up to bed line

Step 3: Second paint of prep

The start of something new!

This blog is being set up as a resource for OR nurses to learn about best practice and surgery.  The great thing about this is that it is accessible from work and home allowing for the flexibility nurses need when preparing for a slate.  Feel free to submit your feedback and suggestions as to what would be most useful for you!