Disinfection solutions before surgery

Disinfection before surgery is crucial. The purpose is to kill microorganisms on the surface and deep layers of the skin in the surgical area and minimize the risk of infection at the surgical site. The following is an introduction to the disinfection of surgical personnel and the disinfection of the skin in the surgical area of ​​the patient:

Disinfection of surgical personnel
Preparation before hand washing

Change the special washing clothes and pants for the operating room. The top should be tucked into the waistband to prevent loose clothes from carrying bacteria.
Wear a mask and hat. The mask should completely cover the mouth and nose, and the hat should cover all the hair to prevent bacteria from contaminating the surgical area.
Trimming nails, removing dirt under the nail edge, and avoiding dirt and dirt from becoming a breeding ground for bacteria.
The skin of the hands and arms should not be damaged or infected. If there is any, you should not participate in the operation to prevent the spread of bacteria and cause infection.

Traditional soap brushing technique
Wash your hands and arms with soapy liquid, rinse with running water, and initially clean the dirt and some bacteria on the skin surface.
Dip a sterilized brush in soap solution and scrub the fingertips, fingers, palms, back of hands, wrists, forearms to 10cm above the elbows on both sides alternately in a certain order. Pay attention to the nail edge, nail groove, finger webs and other parts that need to be carefully scrubbed. Each arm scrubs for about 3 minutes, scrubs 3 times in total, and the total time is about 10 minutes.
After each scrubbing, with fingers facing up and elbows facing down, rinse the soap solution on the arm with running water to prevent sewage from flowing to the hands and causing contamination.
Dry the arm from hand to elbow with a sterile towel. The towel that has been wiped on the elbow should not be used to wipe the hand again to prevent the cleaned hands from being contaminated.
Soak both hands and forearms in 70% alcohol or 0.1% benzalkonium bromide solution for 5 minutes, and the soaking range is 6cm above the elbow to further kill bacteria on the skin surface.

Iodine brushing technique
Wash both hands and arms with soap and running water to remove dirt and some bacteria.
Dip a sterile brush in the iodine solution and scrub your hands and arms alternately in the order of fingertips, fingers, palms, back of hands, wrists, forearms to 10cm above the elbows. Scrub each side for 3 minutes, 2 times in total, about 6 minutes.
Rinse the iodine solution off your arms with running water, and keep your fingers facing up and elbows facing down to avoid sewage backflow.
Dry with a sterile towel, then apply gauze soaked in iodine to your hands and forearms 2 times. After drying, you can wear surgical gowns and gloves to form a protective film for continuous sterilization.

No-rinse hand disinfection method
First wash your hands and arms with soap and running water to remove dirt.
Apply an appropriate amount of no-rinse hand disinfectant to your hands and arms, apply and rub evenly according to the requirements of the product manual, and ensure that the disinfectant covers all parts of your hands and arms. The rubbing time is generally 1-3 minutes. The active ingredients in the disinfectant can quickly kill bacteria.
After the disinfectant dries naturally, you can wear surgical gowns and gloves to form a protective film.

Disinfection of the patient’s surgical area skin
General preparation
The patient’s surgical area skin should be cleaned before surgery. If there is hair that affects the surgical operation, it needs to be removed or cut short before surgery to avoid skin damage. Usually, a special disposable skin preparation knife or electric shaver is used.
For grease and tape marks on the skin, gasoline or turpentine can be used to wipe it clean to ensure that the disinfectant can better contact the skin to work.

Selection of disinfectant
Iodine tincture: It is a commonly used disinfectant in clinical practice. It has a good killing effect on bacteria, viruses, fungi, etc., and is less irritating. It can be used for skin disinfection of various surgical sites. Generally, an iodine tincture solution with an effective iodine content of 0.5% – 1% is used.
Iodine tincture (tincture of iodine): It has strong bactericidal power and can kill bacteria, spores, fungi, etc., but it is more irritating to the skin and has a staining effect. When commonly used for skin disinfection, 2.5% – 3% iodine is generally applied to the skin, and then 70% alcohol is used for deiodination twice after drying to remove residual iodine and prevent skin damage. It is not suitable for surgical disinfection of mucosa and perineum.
Alcohol: Generally, 70% – 75% alcohol is used, which can denature bacterial proteins and exert a bactericidal effect. It is often used for skin disinfection of people who are allergic to iodine, but alcohol has no killing effect on spores and viruses, and is highly irritating, so it cannot be used for mucosal disinfection.

Disinfection range
The disinfection range should include an area of ​​at least 15cm around the surgical incision to ensure that even if bacteria spread due to surgical operations during the operation, they are within the disinfected area. The specific disinfection range of different surgical sites is different:
Head surgery: head and forehead.
Neck surgery: from the upper lip to the nipple, and from both sides to the anterior edge of the trapezius muscle.
Chest surgery: from the clavicle to the shoulder, from the umbilicus to the level, and from both sides to the posterior axillary line, including the axillary fossa on the same side.
Abdominal surgery: from the xiphoid process to the upper 1/3 of the thigh, from both sides to the mid-axillary line, including the vulva.
Limb surgery: centered on the incision, 20 cm above and below, generally beyond the joints.
Disinfection method
Apply from the center of the surgical area to the surrounding areas. If it is an infected wound or anus or perineum surgery, apply from the periphery of the surgical area to the infected wound or perineum and anus.
When disinfecting, sterile cotton balls or gauze should be dipped in disinfectant, and apply in a certain order. Do not omit it. Generally, apply at least 2-3 times. The direction of each application should be consistent, and the disinfection range of the latter time should be slightly smaller than the previous one.