How do you clean a really long incision (sterile technique)?

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I haven't had to do one yet, but I watched my really nice RN do one today. The incision on the patient was a really long midline incision closed with staples (it took two of the longest Mepores to full cover its length). In school they teach us to go down the length, then one on each side, etc. But for such a long incision that seems kind of awkward. Does doing brief zigzags across like my nurse did best maintain sterility? I'm worried about bringing bacteria from the surrounding skin into the wound, but how else would you do it? Do several straight strokes down the length?

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I was taught to cleanse the area directly over the wound from top to bottom, then with new gauze clean area on the side of wound top to bottom, and the other side with new gauze, working outwards away from the wound.

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V

Like this? (pretend the V is centred.. it's supposed to be an arrow pointing down). The problem though is this is a such a long wound, and this method is going to be very time consuming. I don't mind doing it as a student but what do actual nurses do?

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No.... excuse my paint skills haha... black line in middle is incision... orange is first swoop and so on.

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Haha aww thanks for taking the time to do that!!

You would do that for a really long incision though? I think if left to my own devices, I would have ended up doing the same but with a bigger piece of gauze (so I can blame my schooling if it were the wrong method :3). My instructor said the zigzag was the correct way though. I dunno I guess they could both be right.. I'm just being pedantic.

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I would use a new piece of gauze for each swoop... it wouldn't hurt to use a new one half way through one swoop.

side note: swoop is such a great word.

When in doubt check policy. I wouldn't go by what a nurse on the floor tells you. I had one tell me that giving placebo's (for pain) was perfectly fine. Yeahhhh no.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I do zigzag...clean to dirty. Center swooping outward. New gauze each time.

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I would use a new piece of gauze for each swoop... it wouldn't hurt to use a new one half way through one swoop.

side note: swoop is such a great word.

When in doubt check policy. I wouldn't go by what a nurse on the floor tells you. I had one tell me that giving placebo's (for pain) was perfectly fine. Yeahhhh no.

Yeah an RN suggested using a placebo once too, but it was well-intentioned. The patient was really, really constipated and kept requesting more hydromorphone.

My nurse yesterday was super cool. What got me skeptical is that a safety huddle revealed that this unit has the highest infection rates of all the hospitals in our region or health authority, even when adjusted for population factors... so I'm just a little worried I might, might learn something wrong. I don't think there's such a policy on this on our unit.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Yeah an RN suggested using a placebo once too, but it was well-intentioned. The patient was really, really constipated and kept requesting more hydromorphone.

My nurse yesterday was super cool. What got me skeptical is that a safety huddle revealed that this unit has the highest infection rates of all the hospitals in our region or health authority, even when adjusted for population factors... so I'm just a little worried I might, might learn something wrong. I don't think there's such a policy on this on our unit.

We used to use placebos...years ago...and they worked. Today however we do not.

Wounds are really not sterile it's more aseptic. Infections are not always unit based. I worked at one facility that found it was a specific room in the OR

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