Surgical Skin Preparation and Patient Care

Skin Preparation Prior to Surgery: Surgical Field Objectives

To facilitate involvement and prevent infection.

Steps:

1. Prepare and inform the patient about the materials.
2. Accommodate and expose the area, protecting it with a towel.
3. Prepare bed linens.
4. Inspect the area to be shaved.
5. Cut long hair with an electric razor and discard it.

Wet Preparation:

• Lather the area with wet gauze soaked with antiseptic soap.
• Shave the skin, stretching it without causing abrasions.
• Wash the area with antibacterial soap and dry thoroughly.

Dry Preparation:

• Shave the skin, stretching it without causing abrasions.
• Wash the area with antiseptic soap and dry thoroughly.

6. Collect the swab, ensuring no hairs remain on the bed.
7. Dispose of the razor in the appropriate container.
8. Notify the nurse to review the area.
9. If there are injuries or abrasions on the skin, inform the nurse and document it on the nursing sheet.

Comments:

• The skin is prepared hours before the procedure.
• Wet preparation is used on the head and face.
• The patient should shower or bathe in bed after shaving.
• In women, do not shave the face or neck unless specifically indicated by the surgeon.
• In kidney or thoracotomy operations, prepare the armpit as indicated by the surgeon.

APR Functions in the Surgical Area:

• Cleaning of instruments, equipment, and surfaces (according to protocol).
• Sending instruments to the central sterilization unit (clean, dry, and in special containers).
• Receiving instruments and textile equipment from the sterilization center (check that containers are sealed and that the indicator has changed color).
• Replacing materials.
• Collecting disposable material (depositing it in appropriate containers).
• Receiving the patient in the pre-operative area, identifying them, and verifying that they have their medical history. Check their hygiene and shaving.
• Transferring the patient.
• Providing psychological support.
• Collaborating with the surgical team.
• Moving the patient to the recovery/awakening unit.

Postoperative Care

Immediate Postoperative Care (Recovery Unit)

Begins when the patient is brought to the recovery/awakening unit (A-D). Care is provided to minimize pain and prevent complications.

• The surgical bed is prepared.
• The patient is covered with blankets and secured with safety rails, taking care with surgical wounds.
• Organ system function and fluid balance will be assessed through vital signs monitoring.
• The patient is placed in the lateral position or with the head tilted to prevent choking if vomiting occurs.

Mediate or Continued Postoperative Care

Begins when the patient is transferred to a ward and ends with discharge for outpatient follow-up.

Basic Care:

• Take and record vital signs.
• Implement postural changes to prevent pressure ulcers.
• Avoid wetting dressings during hygiene.
• Encourage the patient to expectorate with breathing exercises and attempt to ambulate as soon as possible.
• Observe and verify that dressings are clean, dry, and securely fixed. Provide wound care, drainage management, and catheter care.