skin preps for open heart surgery

heartholder · Jun 10, 2002

well marylynknowles, I have done hearts at 2 different hospitals and one hospital did it with the circle doing the betadine scrub then dry and the scrub tech doing the betadine paint.

the other hospital the circle did entire prep. it was a complicated prep but when you think about it, it was a good prep.

the circle first prepped the chest to umbilicus, then changed gloves and did the legs to the groin. then changed gloves and did the groin. then using an alcohol soaked lap sponge, total of 5 laps. 2 on the chest area, one for each leg and one for the groin. (changing gloves inbetween chest , legs and for the groin) then the circle did the betadine paint, using the same technique as the betadine scrub. is that clear as mud??????????:biggringi

nrw350 · Jun 10, 2002

Dag gum!! That is a lot of cleaning. No wonder many medical professionals are becoming allergic to latex!!!

Nick

RockieSis · Jun 15, 2002

Marilyn,

Where I work in Mississippi, the floor nurses shave the pt no more than two hours prior to surgery time. Once in position and intubated, etc, etc, we begin the prep with the legs up on a leg holder and prep all around the legs, groin, abdominal area, and the chest up to the chin and ear lobe and out onto the upper arm, whatever skin can see the light of day is going to get "painted". We use a product called Duraprep. You paint it on with a sponge applicator. We use about six per patient. It is much neater and not as sloppy /wet as a traditional Betadine scrub/prep. We change gloves and of course change applicators when indicated. Although we are a new program, ongoing for about a year, we have not seen any post op sternal infection (knock on wood). Feel free to email about product info if you like.

kbtoys

RockieSis · Jun 15, 2002

Marilyn,

I forgot to mention that this takes any where from 5-8 minutes.

kbtoys.

nrw350 · Jun 15, 2002

Why so much preparation? I mean, it seems a little excessive to clean that much of the patient when you are just working in the chest.

Thanks.

Nick

heartholder · Jun 15, 2002

we don't just work on the chest. the vein for the graft is often taken from the legs. the vein usually comes from the greater saphenous vein, but with the prep that RockieSis mentions, you can also use the lesser saphenous vein. we only prep the back of the leg when the lesser saphenous is taken. the radial artery can also be used as a vein graft. and I have heard of taking the gastric artery, but have never seen it.

hope this helps you understand the complexcity of the prep

nrw350 · Jun 15, 2002

hmm, interesting. I hope I never have to go thru such a surgery.

Nick

stevierae · Jul 22, 2002

Betadine gel or Duraprep. Works on contact, better coverage, a lot less sloppy then betadine scrub and paint.

I thought the old "timed" preps were sacred cows that most institutions had done away with.

DIPLOMATICRN4HIRE, MSN, RN · Aug 31, 2002

If its a planned cabg... the night before thier shaven and given a nice betadine scrub down, and then when in the OR we duraprep them from chin to toes, even arms just in case we take a vein. Works well and saves on time. full prep less than 5 minutes

on emerg cabg -alcohol and duraprep from chin to toes , both are then covered with ioban. works well .

zoe

MelvaL · Nov 3, 2005

The latest among these messages is June 2002. Has there been any improvements and/or changes in these procedures? Thanks ...

MelvaL

cocothemonkey · Nov 4, 2005

The nurse wipes the patient's chest and legs down with alcohol and the surgeon then durapreps.