skin prep

CDS, Thanks for the good information you have told us about preps. Good reminders. In my OR in Louisville, KY we are working hard to choose and use the best preps. We have found that most surgeons don't really have a preference. They just want to keep moving. Chloraprep is used by most of our specialities - ortho too. This is based on info that the staff has provided about CHG, the active ingredient, being by far the best antimicrobial in all studies. Surgeons don't seem all that educated on skin preps. When one of them started asking for CHG (Hibiclens) I thought, well good, this guy has read some research. Well, no that wasn't the case. He was tired of hearing his patients complain about the "orange stain" on their skin.

CDS, we are very aware of the upcoming re-imbursement issues for infections. Working hard on prevention.

We don't currently have a solution for the lady partsl preps, though. We have read the product guidelines about not using it perineally.

Deb

For lady partsl preps try Technicare.

There are not many alternatives other than betadine for lady partsl preps

you just aren't supposed to use the scrub only the solution.

We use Technicare for our iodine sensitive patients.

It's good for facial preps--it's not so good for ortho, but preps are like pesticides. some kill fleas, some don't.

And you're right about doctors not knowing much about preps.

We must help them to know.

:typing

When doing a vag prep JCAHO/AORN state that you should prep clean to dirty but prevent any splashing to go onto a preped abdomen. So to prevent splashing we have always preped the lady parts first and then prep the abdomen. How many people are using hibiclens for the perineum prep? We have a new surgeon who wants to use hibiclens for the perineum and we also have a infection control nurse who would like us to use chloraprep on the perieum. ANY using chloraprep on the perineum? I don't like the idea very much.

No our hospital does not condone or support the use of CHG for mucous membrane preps. Manufacturers' instructions state not to do this. We were using Technicare, but that is unavailable at this point. We recieved approval from INfection Prevention to use an alternative to Technicare--we use PCMX and have 1995 Mangram resource for that. It is the only option other than povidone iodine. Alot of research went into it.