Lefebvre Marion, Consiglio Lefebvre Mélanie, Notin-Coutant Sophie, Marini Hélène, Merle Véronique
Department of Infection Control, Rouen University Hospital, Rouen, France; Research team "Dynamique et Evénements des Soins et des Parcours", Le Havre, France.
Rouen University Hospital School for Operating Room Nurses, Rouen, France.
GMS Hyg Infect Control. 2025 Jun 26;20:Doc32. doi: 10.3205/dgkh000561. eCollection 2025.
The preoperative shower (POS) is strongly recommended in skin preparation before surgery, to remove skin soiling and facilitate the antisepsis of the incision site. The effectiveness of POS to achieve clean skin in routine practice has not been studied in literature. This study aimed to determine how often the operating room (OR) nurse assessed the skin of surgical patients at arrival in the OR as "not adequately clean".
This descriptive survey was carried out in January 2024 in a university hospital in France. An investigator documented patient's age, gender, and body mass index (BMI), the day of surgery, type of surgical procedure, whether it was scheduled or unscheduled, and the site of the site. The patient was asked whether s/he had taken a POS, and its time and place (home or hospital). The OR nurse was asked by the investigator about her assessment of the patient's skin cleanliness (adequate or inadequate), and in case of skin cleanliness deemed unsatisfactory, what decision had been made: proceed as usual, additional skin cleaning in the operating room, postponement of the surgical procedure.
Among the 100 patients included in the study, 18% (95% CI 10.5-25.5%) had a skin cleanliness that was considered unsatisfactory. A scheduled procedure was the sole parameter significantly associated with satisfactory skin cleanliness as compared to unscheduled procedures.
Despite the POS, approximately one-fifth of patients had inadequate skin cleanliness upon arrival in the OR, highlighting an essential area for improvement of preoperative preparation of the surgical field, especially in clean surgery.
术前沐浴（POS）在手术前皮肤准备中被强烈推荐，以去除皮肤污垢并促进切口部位的消毒。在常规实践中，POS实现皮肤清洁的有效性在文献中尚未得到研究。本研究旨在确定手术室（OR）护士在手术患者到达手术室时将其皮肤评估为“清洁不充分”的频率。
这项描述性调查于2024年1月在法国一家大学医院进行。一名研究人员记录了患者的年龄、性别、体重指数（BMI）、手术日期、手术类型、是否为择期或非择期手术以及手术部位。询问患者是否进行了术前沐浴，以及沐浴的时间和地点（家中或医院）。研究人员询问手术室护士对患者皮肤清洁度的评估（充分或不充分），以及在认为皮肤清洁度不令人满意的情况下做出了什么决定：照常进行、在手术室进行额外的皮肤清洁、推迟手术。
在纳入研究的100名患者中，18%（95%置信区间10.5 - 25.5%）的皮肤清洁度被认为不令人满意。与非择期手术相比，择期手术是与满意的皮肤清洁度显著相关的唯一参数。
尽管进行了术前沐浴，但仍有大约五分之一的患者在到达手术室时皮肤清洁不充分，这突出了手术野术前准备中一个需要改进的关键领域，尤其是在清洁手术中。
