It is advised that you should not wear lotion, creams, or any topical products before surgery. These products can compromise patient safety and interfere with the medical equipment used during the procedure. A clean, bare skin surface is paramount for accurate monitoring, effective infection control, and the safe use of surgical devices. Understanding the reasons behind this rule ensures a safe and successful surgical experience.
The Critical Reasons for Avoiding Topical Products
Lotions and oils interfere with vital sign monitoring equipment. Products containing oils or moisturizing agents prevent the adhesive on electrocardiogram (EKG) leads and other monitoring dots from making proper contact with the skin. If electrodes cannot stick firmly, they cause artifact or interference in the readings, leading to inaccurate data on your heart rate and rhythm. This interference makes it difficult for the anesthesia team to accurately track your condition.
Certain topical products compromise the effectiveness of infection control measures. Surgical preparations involve cleansing the skin with a specialized antiseptic agent, such as Chlorhexidine Gluconate (CHG), which binds to the skin to kill bacteria. Applying lotion or oil after this wash creates a barrier that prevents the antiseptic from working correctly. This blockage raises the risk of a surgical site infection (SSI).
A major safety concern involves the use of electrocautery. This device, which uses an electrical current to cut tissue and stop bleeding, requires a grounding pad to safely draw the current away. If lotion or cream is present under the pad, it acts as an insulator, reducing the contact area. This causes the electrical current to concentrate, generating excessive heat and potentially causing a severe burn.
Defining All Products That Must Be Avoided
The prohibition extends beyond standard body lotion or moisturizing creams. Any product applied to the skin, hair, or nails in the hours leading up to surgery must be avoided because it leaves a residue that interferes with safety protocols. This includes body oils, powders, and heavy applications of deodorant, which interfere with electrode placement and antiseptic efficacy.
Makeup, including foundation, powder, and heavy concealers, must be completely removed before arrival. The surgical team needs to see your natural skin tone, as changes in color around the lips and nail beds indicate circulation and oxygen levels. Eye makeup like mascara and eyeliner is also prohibited because particles can irritate the eye if the eyelids are taped shut during anesthesia.
Nail polish, gel nails, and acrylics must be removed from at least one finger on each hand. The pulse oximeter, a device that clips onto the finger, measures blood oxygen saturation using light. Polish or artificial nails can block this light, leading to an inaccurate or unreliable reading.
Hair products like gels, sprays, and heavy conditioners should also be avoided. They can be flammable and may leave residue on the head, which is often an area for electrode placement.
Preparation Steps for the Night Before and Morning Of
Surgical preparation begins well before leaving for the hospital, often involving a specific showering routine. Many facilities mandate a pre-operative scrub using an antiseptic wash, such as Chlorhexidine Gluconate (CHG), the night before and the morning of the procedure. This special soap is applied from the neck down, focusing on the surgical site, and must be rinsed off completely.
Do not apply any lotions, powders, perfumes, or creams after the antiseptic wash. Applying products defeats the purpose of the scrub by coating the skin and preventing the CHG from forming its protective, germ-killing layer. This final step should occur just before putting on clean clothes.
The final cut-off time for product application is immediately following your last required antiseptic shower. On the morning of surgery, arrive at the facility with completely clean, dry, and bare skin. If you accidentally apply a prohibited product, call the surgical center immediately for instructions. Do not try to aggressively scrub it off yourself, as they may instruct you to wipe the area or perform a partial antiseptic wash upon arrival.