alternative solutions for a vaginal prep

Specialties Operating Room

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What are people using if patient is allergic to betadine for internal lady partsl preps ? Phisohex says for external use only and Hibiclens says not to use on genitalia.

My gyn specialty manager said she read to use baby shampoo as an alternative for a lady partsl prep.

Specializes in 2 years school nurse, 15 in the OR!.

We called the AORN over this and our local woman's hospital. They said they are using Chlorhexadine at this time. AORN suggested this as well in the interim. It's upsetting because it CLEARLY says not to use in genitals and mucous membranes. Ugh, what are we supposed to do? The lady at AORN suggested rinsing it well with saline following use. The woman's hospital is using it in L & D at this time as well. We are really stuck for now. I hope they release Technicare sometime soon!

The gyn onc I worked with insisted on using Hibiclens and nothing else for lady partsl prep. This was for every patient every time. He was very emphatic so I did. What else could I have done? I know of no good solution.

Specializes in OR-General and Burn and Wound.

I am so frustrated because I have not been able to find anything to replace technicare. I have bee forced to use the Exidine prep solution for preps in areas in which the label warns against (head, face, eyes, ears and genitals). I am now pressuring management to either step up to the plate and make a decision about a replacement until Technicare is released. I am praying that no patient has a negative outcome by using the product. It is difficult to see burns and necrotic areas of wounds when Betadine is used. Is Dial or Nutregena liquid bacteriostatic?

Specializes in OR-General and Burn and Wound.

You can only do what you are told to do if you dont have management to back you up if you go against the surgeons wish. Just document, document, document to CYA!!!!

Specializes in OR-General and Burn and Wound.

Me too!!!

Specializes in surgical, emergency.

We use Hibiclens (?sp) for the majority of our lady partsl preps. One doc still likes Betadine Scrub for lady partsl preps.

We were told a while back that we were to use Hibiclens full strength. I still can't quite bring myself to that. I still dilute with a bit of sterile water. Same for Betadine Scrub, I'll dilute a little.

We use Durapreps for our abdominal and extremity preps, unless an open wound or oriface is involved.

We did an open fx repair on a wrist the other night....I wen't back to Betadine Scrub and Solution, the doc was good with that. All turned out fine.

I know what the back of the bottles say, I've seen the studies, but I've been doing this for over a quarter of a century and have seen little problems. I know that' probably not a real argument....."always done it this way".......but I don't really see a real alternative!!

Mike

Specializes in OR RN Circulator, Scrub; Management.

Spoke to Technicare Friday and they are close to releasing but doing back orders first so get on the list.

Our gyn surgeons are also wanting the Hibiclens. Our facility requested the MD's to sign off and assume the liability of it used in the OR for vag preps. Literature is found for and against it so who is right??? The MD's I work with say that the lady partsl mucosa is not a mucous membrane and in actuality has the properties and make up of our skin.

I realize this doesn't solve it but does raise the question.

We have been using Hibiclens 0.4% diluted with sterile water to 0.2% for a few months now on all lady partsl preps. I make sure and document the solution in the chart. Out managment wants us to use this instead of Betadine that we had been using. We have not had any complications so far. :eek:

I was really interested to find this thread as we have surgoens here in Tasmania who wish to use alcoholic chlorhexidine for ALL prep, lady partsl, on the face etc. I am amassing evidence to counter their argument but I too have been told that vag lining is squamous epithelium ie skin. I asked a surgeon why it doesn't look like the rest of our skin & he didn't know. If anyone can send me references to scholarly article that would help me I'd be most grateful. Cheers

Our OB/Gyn and Urologic surgeons request Chlorhexidine even if the patient isn't allergic to betadine. They don't like the residual brown when using scopes

Thanks for such a quick response. My main concern is that the surgeons want to use 70% alcohol-based chlorhex. As a woman I and my colleagues intuitively feel it's wrong & this weekend I have just conducted a personal experiment & I KNOW it's wrong! It's the alcohol I'm combatting as much as the chlorhexidine. Hope you've got soem evidence that can help. Thanks, R

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