prep question

[PureLifeRN]

Hello! Quick question from a newbie....

When you are prepping an open contaminated wound (i.e. pressure ulcer), I know you prep that actual wound last, but do you prep starting from the perimeter of the wound out, or from outer skin in towards the wound? thanks!

[canesdukegirl, BSN, RN]

I always irrigate any open wounds prior to prepping. In this case, you would use CHG or betadine. Start by packing the open wound with sterile gauze first, and then using another sterile sponge, prep around the periphery of the wound outward. When you have prepped from the edges of the wound out toward the periphery of your surgical site, then remove the gauze and with another sterile prep sponge, prep the wound.

If you were prepping an area where a stoma is present, you would clean the stoma and then cover it with an occlusive dressing such as Tegaderm. Then you would prep from the edges of the stoma outward.

Did that make sense?

[PureLifeRN]

So if this was a pressure ulcer, you would put sterile 4x4 or something on it wound, then using betadine scrub outward....would the 4x4 be soaked with sterile NACL or just dry?

Could you use scrub and paint? or just betadine paint?

:) thanks!

[canesdukegirl, BSN, RN]

You can just pack the wound with a dry sponge, because the irrigant that you used to clean it first will moisten it. Typically for open wounds, our docs just use paint. Always ask them what they want, though. Some surgeons HATE betadine and prefer only CHG.