Preliminary patient preparation
For the successful performance of elective surgery, preparation begins in advance. On the day before the scheduled procedure, the patient takes a general hygienic bath, followed by a complete change of linen.
On the day of surgery, preparation continues directly in the area of the future surgical access. Hair removal is performed using exclusively the dry shaving method. Immediately afterwards, the skin in the intervention area is wiped with alcohol.
Classic Grossich-Filonchikov method
The main antiseptic standard on the operating table is the Grossich-Filonchikov method. A 5% alcoholic iodine solution is used as the active substance. The use of modern iodophors (iodine complex with potassium iodide or povidone-iodine) is also permitted.
The technique implies strict fourfold application:
- Broad wiping of the surgical field before isolation.
- Re-application of antiseptic to the surgical site after draping with sterile linen.
- Treatment of wound edges before skin suturing.
- Final application to the intervention area after suturing.
Alternative antiseptic methods
If an adult or child has an iodine intolerance (allergy), the Backal method is used. In this case, the surgical field is treated with a 1% alcoholic solution of brilliant green.
Another reliable option is treatment with chlorhexidine. For this purpose, a 0.5% alcoholic solution of chlorhexidine is used — the same concentration applied for surgical hand disinfection.
Features of emergency surgery
When performing emergency surgery, the preparation algorithm has an important feature. The preparation includes the following steps:
- Rapid hair shaving in the access area.
- Mandatory preliminary skin preparation with 0.5% ammonia solution for cleansing.
- Application of the main antiseptic using one of the aforementioned methods (classic, Backal, or chlorhexidine).
The four-step rule for the Grossich-Filonchikov method: "Before draping, after draping, before sutures, after sutures."
Class and exam questions
How to properly remove hair before surgery?
Hair is shaved directly on the day of surgery, using the dry shaving method only at the surgical access site.
Which antiseptic to choose in case of iodine allergy?
In case of iodine intolerance, the Backal method is used, which involves the application of a 1% alcoholic solution of brilliant green.
How does field preparation differ in emergency surgery?
The main difference is the need for additional skin preparation with a 0.5% ammonia solution before applying the primary antiseptic.
What else to study on this topic
- Mechanism of antimicrobial action of iodophors
- Comparison of alcoholic chlorhexidine solution and brilliant green
- Rationale for using 0.5% ammonia solution in emergency surgery
- Complications resulting from improper surgical field preparation
Master the entire topic in the "General Surgery" course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "Surgical field preparation" and 3,335 more subject pages
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 70 video lessons on the subject
Other topics in the section "CHAPTER 2. ASEPSIS AND ANTISEPSIS"
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.