Surgical Skin Preparation Set

Despite many advances in surgical asepsis, surgical site infection (SSI) remains a challenging and costly problem. Decontamination of the skin with an antiseptic agent is standard practice before any trans-cutaneous invasive procedure. The preparation process of the surgical site skin (patient skin preparation) is called prep, and the package that contains items for disinfection is called the prep set.

What’s the Prep set?

The skin has two layers; dermis and epidermis.

The cells of the outer layer of the epidermis are constantly shedding and are pushed up again by the cells of the lower layer.

Metabolic wastes, along with sweat secreted by the sweat glands of the dermis, travel to the epidermis and are replaced on the skin.

All these secreted substances and microorganisms should clean up with antiseptic solutions before surgery.

This disinfection is done after the patient is placed on the operating table and anesthetized.

The preparation operation should take at least 3 to 5 minutes; because the effects of these solutions are not immediate and require time.

Although the skin is not sterilized by this, it’s largely disinfected.

Skin Preparation Standards

 I. The patient and surgical team members should follow the surgeon’s preoperative orders.

Additionally, preoperative preparations (Prep) by the surgical team should complete.

1. The surgeon’s orders may include the patient taking a bath or showering with an antiseptic agent the night before surgery and/or the morning of surgery.

1.1. The CDC recommends requiring patients to bathe or shower with an antiseptic agent the night before surgery.

1.2. If chlorhexidine Gluconate (CHG) is to be used, the following instructions should provide to the patient:

1.2.1. CHG is inactivated by soaps and shampoos. The patient must make sure the soap and shampoo are thoroughly rinsed off prior to using CHG.

1.2.2. CHG is an eye irritant and can burn the corneas as well as be ototoxic.

The patient should be very careful to keep CHG from entering the eyes and ears.

1.2.3. The patient shouldn’t use any body lotion after bathing or showering with CHG.

The body lotion will inactivate the residual bacteriostatic effects of CHG.11

2. The preoperative patient interview should include asking the patient if she/he has any known allergies, as well as a review of the patient’s history and physical.

3. The surgical team should refer to the surgeon’s orders pertaining to hair removal (also referred to as “shave prep” in this document) that should or shouldn’t perform prior to skin prep.

4. The patient’s body jewelry should remove from the area of the skin prep.

5. Patient education should include informing the patient to not wear any cosmetics on the surgery date.

Cosmetics can inhibit the effectiveness of the antiseptic solution.

6. For surgery that involves the fingers, hand, or wrist, the patient should cut the nails short, thoroughly clean the subungual areas during the preoperative bath or shower, remove artificial nails and nail polish.

 II. The healthcare facility should use medical standard-approved agents that have immediate, cumulative, and persistent antimicrobial action.

1. The skin prep agents should have the following properties: fast-acting, persistent and cumulative actions, and non-irritating.
2. The surgical team members and infection control supervisor should involve in the process of evaluating and selecting the skin prep agents.

 III. Alcohol is an accepted antiseptic agent; however, it should not use as a single agent but as part of the skin prep regimen (surgical skin preparing).

1. The antimicrobial action of alcohols is the denaturing of proteins. 60%-95% alcohol is the most effective.
2. Alcohol has broad-spectrum antimicrobial properties, including the ability to destroy Gram-positive and Gram-negative bacteria as well as multidrug-resistant pathogens including MRSA and VRE, Mycobacterium tuberculosis, and fungi.
3. Alcohols have rapid activity when applied to the skin, but alone do not have persistent.
4. When using an alcohol-based solution, the healthcare facility procedure for performing skin prep should follow the manufacturer’s instructions since the instructions can vary according to the solution that’s in use.
5. The alcohol-based solution should not use when the patient’s skin is visibly dirty or contaminated with proteinaceous materials since that decreases the antimicrobial action of the alcohol.
6. Alcohols are flammable and therefore, must be properly stored according to National Fire Protection Association recommendations, as well as local and state regulations.

Surgical team members should perform a standardized patient skin prep procedure based upon the manufacturer’s written instructions that are specific to the using antimicrobial agent and according to healthcare facility policy and procedures.

Purpose of the prep process

1. Reducing the number of microorganisms in the patient’s skin as much as possible
2. Cleansing the skin of any mass and fat, to reduce microorganisms as much as possible
3. Apply a layer of disinfectant on the skin to temporarily prevent the growth of microorganisms during the operation

Please note that the skin preparation applies to a large area of skin because:

1. The operation site skin should be sufficiently visible and the unprepared environment should not expose by moving them.
2. Sometimes it’s necessary to increase the size of the incision at the surgical site during operation.

The process of preparing the skin before surgeries need instruments and some equipment that must be sterile and all of these accessories collect in one pack. This package is called “Prep set”.

AJP surgical sets

• DRESSING SET
• SURGICAL SKIN PREPARATION SET/KIT

Contents of the AJP surgical skin Preparation set

The main composition in the prep set containing sterile items are as follows:

• Ring forceps (1pc)
• Ball gauze (4pcs)
• Gauze (6pcs)
• Three-piece container (1pc)(designed to use three solutions)
• Drape (1pc)
• Dryer drape (1pc)

Dear customers: Each carton contains 100 prep sets and the minimum order is one carton.

How to use the AJP surgical Prep set

• while opening the sterilized package please note that doesn’t come out of the sterile when opened.
• Spread the plain drape under the incision site so that the surrounding areas do not become wet and dirty.
• Pour antiseptic solutions and, if necessary, Physiological serum into a part of the three-part container.

Be careful not to contaminate the inside surface of the sterile container.

• First, wash the incision site from the inside to the outside of the area for 3 to 5 minutes using sterile gloves and an antiseptic solution.
• Then take the dryer that’s in the set and slowly spread it on the washed area to absorb the solution and dry the surface.
• In the following, take the dryer drape from the top edges and lift it off the surgical site, and then set it aside.
• Using ring forceps and small sterile ball gauze and sterile gauze, agitate and soak the surgical site with an antiseptic solution (green betadine or other disinfectants).
• For this purpose, the gauze impregnated with the antiseptic solution should move from inside to outside the surgical site in a circular motion several times.
• Dispose of used items hygienically.
• These sets are sterilized by ethylene oxide (EO) autoclave.
• To ensure the sterile process, we included an EO indicator in the set, so that in addition to the indicators on the packaging and the main tests during consumption, you can use it for viewing and archiving.

Usages of AJP prep set (skin preparation)

• AJP prep Set is used in the operating room (OR) preoperative to patient skin preparation in various surgeries.
• Also in the emergency room and various treatment departments, the medical staff uses it for catheterization, local anesthesia, and similar tasks.

Storage conditions and non-use cases

• Do not use the package if it is open or damaged.
• Please do not use the product after the expiration date.
• The sterile prep set is disposable, so don’t re-sterilize it.
• In order to maintain health, please discard it hygienically after using this product.
• In order to maintain the quality and prevent damage to the package, keep it away from sunlight and in a dry, cool place without any high pressure.

Unique features of AJP surgical skin preparation set

• The distinguishing feature of the Asia Jarah Pishro (AJP) Prep set is the sterile and disposable plastic ring forceps we designed it very lightly. However, it has a function completely in accordance with its metal model.
• Also, the solution dish, which has three containers to use three solutions, is another distinguishing feature of this company’s prep sets.