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Vaginal preps, help!!


Hi all,

I'm new in a specialty hospital that primarily does OBGYN surgeries. I am not new to the OR, but GYN is new. I know vaginal preps are constantly debated, but I have been searching and researching this topic with no consistency in answers found- even on AORN. I have seen different RN's do the vaginal prep all a variety of ways but am trying to develop my own routine and way to do it-- right now I'm way too slow because I can never decide which order is the "right way" to prep in and which sponges/sponge sticks to use in which order for the betadine scrub and solution prep tray. I understand both sides of the logic-- some people say incision outward (with idea that vagina is "incision area" so start vag first then out to thighs) and others say clean to dirty (start mons pubis, then thighs inward), so I am just confused and want to do the best job I can for my patients.

If you guys could share with me the order you do your vaginal preps I would really appreciate it!! (ex. start at mons pubis, then down labia middle and both sides before starting on thighs, OR down labia and perineum then one labia/thigh side at a time, AND start at thighs working inward then labia-- OR start at labia and scrub out toward thighs?).

Thanks so much!

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

Vaginal prep first, then discard the prep stick. Then do mons/labia with another prep stick that is then discarded. Then thighs. Dirty to clean with reasoning being if anything from dirty gets on clean, it is then cleaned off.

Thanks for your response, Rose Queen! You mean vaginal vault prep first?


Specializes in Peri-Op. Has 10 years experience.

I put in a very wet vag prep stick first, I leave it in while I then do the external vaginal prep(mons/labia), I then pull out the prep stick and move to the inner thing and another swipe higher on the mons plus a final swipe across the lower buttock/bed crease area.

If an abdominal prep is required, I do that first but with a chloraprep stick.

If a foley is required I do the foley after all the lower prep is complete.

Thank you for your reply!


Specializes in OR Nursing, Critical Care, Med-surg. Has 4 years experience.

This is what I do:

Insert the vagina with a betadine paint prep stick - leave it in then start with the external prep (scrub).

Discard the prep stick that was inserted into the vagina.

Blot dry the betadine scrub (external).

Insert a new prep stick (paint), then discard.

Paint externally with paint.

If it's abdominal and vaginal...I start with vaginal prep, then abdominal prep with a chloraprep stick.

Eventually, it becomes 2nd nature.

Just remember betadine scrub never goes into the vagina, just the paint.

Thank you very much! =)