Preoperative Skin Preparation
Proper preparation of the patient’s skin for surgery renders it as free as possible from microorganisms, which reduces the risk of infection at the incision site.1 This procedure doesn’t duplicate or replace the full sterile preparation that immediately precedes surgery. Before any surgical procedure, the patient should have two preoperative showers with chlorhexidine gluconate to reduce the number of microorganisms on the skin and decrease the risk of contaminating the surgical incision.1
Hair should not be removed from the area surrounding the operative site unless it’s thick enough to interfere with surgery because hair removal may increase the risk of infection. If hair is removed, use electric clippers. Clipping hair should occur immediately before an operation to decrease the risk of surgical
site infection.1,2,3,4 Each facility has a hair removal policy. (See Where to remove hair for surgery.)
site infection.1,2,3,4 Each facility has a hair removal policy. (See Where to remove hair for surgery.)
Where to Remove Hair for Surgery
Shoulder and Upper Arm
On operative side, remove hair from fingertips to hairline and center chest to center spine, extending to iliac crest and including the axilla.
Forearm, Elbow, and Hand
On operative side, remove hair from fingertips to shoulder. Include axilla unless surgery is for hand.
Thigh
On operative side, remove hair from toes to 3” (7.6 cm) above umbilicus and from midline front to midline back, including pubis.
Chest
Remove hair from chin to iliac crests and to midline of back on operative side (2” [5 cm] beyond midline of back for thoracotomy). Include axilla and entire arm to elbow on operative side.
Lower Abdomen
Remove hair from 2” above umbilicus to midthigh, including pubic area; for femoral ligation, to midline of thigh in back; for hernioplasty and embolectomy, to costal margin and down to knee.
Hip
On operative side, remove hair from toes to nipples and at least 3” beyond midline back and front, including pubis.
Flank
On operative side, remove hair from nipples to pubis, 3” beyond midline in back, 2” past abdominal midline. Include pubic area and, on affected side, upper thigh and axilla.