The pre-operative antiseptic shower is a mandated step in preparing for surgery, primarily to reduce the risk of a Surgical Site Infection (SSI). Human skin naturally hosts microorganisms, known as resident and transient flora, which can be introduced into the surgical wound during the procedure. Using a specialized antiseptic cleanser significantly lowers the number of these bacteria on the skin’s surface. This process contributes to patient safety and recovery.
Pre-Shower Preparation and Timing
The timing of the antiseptic shower is scheduled to maximize the cleanser’s effect, which is sustained for several hours after application. Most protocols require two separate showers: one on the evening before surgery and the second on the morning of the procedure. Following the final shower, the skin must not be re-contaminated before the patient arrives at the hospital.
Before beginning, gather all necessary supplies, including the prescribed antiseptic cleanser, a clean washcloth, and two freshly laundered towels and sets of clothing. All jewelry, including rings and body piercings, must be removed, as these items can neutralize the cleanser or trap bacteria. Additionally, all makeup, nail polish, lotions, creams, deodorants, and perfumes must be washed off beforehand, as these products can interfere with the antiseptic’s effectiveness.
The area around the surgical site should not be shaved in the 24 to 48 hours leading up to the procedure. Shaving creates microscopic abrasions that can harbor bacteria and increase the risk of infection. If hair removal is required, the medical team typically performs it just prior to the operation using specialized electric clippers.
Using the Antiseptic Cleanser Correctly
Showering begins with washing the hair and face using regular shampoo and soap, ensuring all residue is rinsed away before moving on to the body. The antiseptic cleanser, commonly containing chlorhexidine gluconate (CHG), is designed to remain active on the skin for an extended period. After rinsing the hair and face, turn the water flow off or step away from the spray.
Apply the cleanser to a clean, wet washcloth or directly to the hand, then rub gently over the entire body from the neck down. Wash the skin gently for a specified contact time, often around five minutes, ensuring the cleanser reaches all skin folds and surfaces. Avoid sensitive areas like the eyes, ears, mouth, and genitals, as the solution can cause irritation or damage to mucous membranes.
Pay attention to the area where the surgery will occur, along with high-bacteria zones like the armpits, groin, and between the toes. After the required application time, the body must be thoroughly rinsed with warm water to remove all traces of the cleanser’s residue. After rinsing the antiseptic, do not use regular soap or body wash, as these common soaps can neutralize the CHG’s residual properties.
Final Steps to Maintain Sterility
Immediately following the final rinse, dry the skin using a clean, fresh towel by gently patting rather than rubbing. Patting avoids irritating the skin and potentially dislodging new bacteria, thereby preventing re-contamination of the disinfected surface. Once dry, the patient must dress immediately in clean clothes, such as freshly laundered pajamas or specific hospital-issued garments.
The skin’s integrity must be maintained until the time of surgery, meaning no lotions, moisturizers, powders, creams, or deodorants should be applied. These products introduce moisture and chemicals that can encourage microbial growth or compromise the antiseptic layer. If the patient must lie down after the shower, they should use freshly laundered bed sheets to prevent contact with household bacteria.
If the clean skin accidentally comes into contact with an unwashed surface, such as a chair or a dirty countertop, the affected area should be re-washed immediately with the antiseptic cleanser and re-dried with a clean towel. These post-shower steps ensure the reduction in skin flora achieved by the antiseptic is preserved up to the moment of the operation.