Scrub Technique for Large Animal Patients Handout
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First,
generously clip the area around the proposed incision with a #40 surgical
clipper blade. Isopropyl
alcohol poured on site will facilitate clipping.
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Vacuum or
brush away and dispose of clipped hair and other debris.
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Perform "gross" preparation with any
available soap (we use an antiseptic surgical scrub, NolvasanR
or BetadineR), scrub brush or sponge, and water.
Continue to scrub and rinse well until area is free from gross dirt
and water beads as it flushes across skin.
It may be necessary to repeat this preparation to achieve the white
glove test of cleanliness. Use
a clean 4" x 4" gauze sponge for the test.
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If the area is to be locally anesthetized, 70%
isopropyl alcohol followed by BetadineR or NolvasanR
solution should be sprayed on the entire site.
The local anesthetic is then injected before the "final"
skin preparation.
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The "final" skin
preparation is actively applied, in a pattern to provide contact time
of five minutes. Saturate 10 to
15 clean gauze sponges with an antiseptic solution (2% NolvasanR
or BetadineR). To
this ten milliliters of NolvasanR or BetadineR
scrub is added to the top sponges.
Starting with 1 to 3 sponges, scrub the skin in small circular
motions, working from the proposed incision site out to the periphery of
clipped area. Discard sponges
as you reach periphery. Repeat
process actively for five minutes. Avoid
moving peripheral debris toward center of clean area.
Rinse with sterile saline or isopropyl alcohol until beading
appearance is present on the skin surface, indicating area is free from fat
and/or soap residue. Avoid
pouring saline near contaminated edges that could backwash over clean skin.
Apply alcohol with spray bottle and let dry. Finish by applying an even coating or NolvasanR
or BetadineR solution with spray bottle.
Area is ready for surgery.
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An alternate final skin preparation is a
commercially prepared product called DuraprepR by the 3-M
Company. It is a faster,
quicker drying, longer-lasting final antiseptic preparation.
The disadvantage is that it costs more.
Before use, dry off grossly prepared area with clean sponges and
alcohol. With the "shoe
polish" type DuraprepR applicator, apply first on
proposed incision area, working outward toward periphery.
Allow prep to dry (approximately one minute).
Area is ready for surgery. Tacky
film residue acts as an antiseptic barrier on the skin.
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