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Skin Prep Response Paper

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An estimated 550–650 surgical fires occur each year in the United States, with 5% resulting in death or serious injury (Rocos & Donaldson, 2012). Surgical fires can have many contributing factors due to the operating room environment as well as substances used in the operating room. As an operating room nurse, it is important to recognize when patient safety is at risk and intervene. I would like to address our current method for skin preparation for craniotomies. When performing surgery on a patients head, they are already at high risk for surgical fire due to the close proximity of the surgical site and anesthesia gases. Alcohol-based surgical preps are used to clean the surgical site prior to surgery presenting yet another risk factor. …show more content…
Alcohol-based skin preps are the preferred preps because of alcohol in inexpensive, readily available, and the most rapid-acting and effective skin prep (Healthcare Traveler,2007). The issue with alcohol-based preps is that the directions for use must be strictly followed to reduce the chance of surgical fire and maintain effectiveness. According to 3M DuraPrep instructions for use, the DuraPrep solution must be allowed 3 minutes to completely dry on the skin and up to 1 hour to dry if applied to hair (2014). Currently, in our facility, the Duraprep solution is applied to the patients unshaved or minimally shaved head for a craniotomy and only allowed a dry time of around 3-5minutes due to the fact that the patient is under anesthesia and waiting a full hour would be impractical. This practice puts our patients at high risk for surgical fire during the surgical procedure, due to fumes from the DuraPrep solution becoming trapped under the surgical drapes and then being ignited by the electrocautery unit during …show more content…
A quantitative study was done to assess whether removal of hair prior to surgical prep effected the rate of postoperative infection in our cranial surgery patients. There were 13 postoperative wound infections out of 980 patients who had no hair removed. There were 12 wound infections out of 1038 patients whose hair was shaved preoperatively (Bekar et al.,2001). The results of this study suggest removal of hair does not increase postoperative infection risk. This study was ranked Level IV on the hierarchy of evidence. A more recent study “authors conclude that there is no evidence to support the routine performance of preoperative hair removal in neurosurgery,” (Journal of Neurosurgery,

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