Step by Step Photo Series of Surgical Prep of the Large Animal Patient
Step 1: Clipping: Generously clip area around the proposed incision with #40 surgical clipper blade. Isopropyl alcohol poured on site will facilitate clipping. Vacuum or brush and dispose of clipped hair and debris.
Step 2: Gross Preparation: Use a surgical scrub product (Chlorhexidine [Nolvasan®], or Providone-iodine [Betadine®]) and tap water. Scrub and rinse until area is free of debris and water beads as it flushes across skin. Rinse with tap water. Down Load video of this step
Step 3: White Glove Test: Soak 10-15 white 4x4 gauze sponges with isopropyl alcohol (70%). Wipe the scrubbed skin (always work from proposed incision site to the periphery) and check for remaining dirt and debris. Discard gauze if you pick up debris. Once you reach the periphery, discard gauze and start again at the proposed incision site with a new gauze sponge.Down Load video of this step
Step 4: Final Skin Preparation: Saturate 10-15 gauze sponges with antiseptic solution (2% Nolvasan® Betadine®). Add ten milliliters of Nolvasan® or Betadine® surgical scrub to the top sponges. Scrub in a circular motion starting at the surgical site and moving toward the periphery. Never scrub in the direction of the periphery towards the proposed incision site. Total contact time should be 5 minutes.Down Load video of this step
When picking up the sponges to begin scrubbing, fold and hold the corners of the sponge so that you do not touch the surface of the sponges that will be in contact with the surgical site. Down Load video of this step Starting with 1 to 3 sponges, scrub in circular motion starting at the proposed incision site and moving towards the periphery. Discard sponges as you reach the periphery (do not move peripheral debris toward the central incision site). Repeat for a total of five minutes. Down Load video of this step
Step 5: Rinse: Rinse with sterile saline or 70% isopropyl alcohol. Continue rinsing until the area is free of fat and/or surgical scrub residue (rinsing solution will bead as it is flushed across skin. Rinsing solution should always flow from central (clean) to periphery (contaminated).
Step 6: Final Antiseptic Preparation: Apply 70% Isopropyl alcohol to skin and let dry. Finish by applying an even coating of 2% Nolvasan® or Betadine® solution with spray bottle. Down Load video of this step
