The effect of nurse-performed preoperative skin preparation on postoperative surgical site infections in abdominal surgery.

Aim: To determine the effect of preoperative skin preparation procedures performed by nurses on postoperative surgical site infection in abdominal surgery.

Background: Despite all interventions, postoperative SSIs still greatly affect mortality and morbidity.

Design: This is an experimental study.

Methods: Procedures developed for nurse application of preoperative skin preparations were tested on a control group (n = 39) and study group (n = 43).

Results: Only clinical routines for preoperative skin preparation were performed on the control group patients. Control group members' skins were mostly prepared by shaving with a razor blade (41%). For the study group members, the researchers used the preoperative skin preparation procedure. Clippers were used to prepare 55.8% of study group members while 44.2% of them were not treated with the clipper because their wounds were clean. As a requirement of the procedure, all members of the study group had a chlorhexidine bath at least twice after being hospitalised and at least once a night before the operation under controlled conditions. In the group where chlorhexidine bath was not applied, the infection risk was found to be 4.76 times (95%CI = 1.20-18.83) greater even after corrections for age and gender had been made. The difference between control group and study group with respect to surgical site infections was also statistically significant (p < 0.05).

Conclusion: Preoperative skin preparation using clipper on the nights before an operation and a 50 ml chlorhexidine bath excluding head area taken twice in the pre-operative period are useful to reduce SSI during postoperative period.

Relevance To Clinical Practice: We find that preoperative skin preparation using the procedures developed as a result of findings of this study is useful in reducing surgical site infection during the postoperative period.