ACT ONE SCENE ONE

THE MAIN EVENT



HOW DO YOU PREPARE THE OPERATION SITE?
Shaving:
The operation area should be clean and free of infection before the operation, and the ward nurse to check this in the ward before sending the patient to the O.T. (Figs 2.12A – E)
- Shave the area on the morning of the operation, or as part of operation.

Preparation:
Prepare the skin as soon as the patient is anaesthetized.
- Start with a soap solution, and follow this with spirit.
- If there is a low sensitivity to iodine in the community, use alcoholic iodine.
- Take a sterile swab on a holder start in the middle of the operation site, and work outwards.
- Discard both swab and holder, and repeat the process with a second swab (some surgeons use a third).
- The last is spirit which will evaporate to leave the skin dry.
- Be sure to prepare a wide enough area of skin.
- In an abdominal operation this should extend from the patient's nipple line to below his groin.

Draping
The skin has been prepared:
-Place the first towel across the lower part of the operation site. fig 2.13a
-Place another towel at right angle on the nearer edge of the operation site. fig 2.13b
-Apply a towel clip at the point of crossing of the two towels. fig 2.14
-Place another towel at the far edge of the operation site.
-The final towel goes across the top end of the site.
All the corners should have towel clips to prevent them from slipping they can go through the skin if the operation is under G.A.
-In an abdominal operation an abdominal sheet covers the abdomen on top of the towels. This sheet has an opening in its middle to provide access to the operation site [double toweling]
-If any area close to the operation site becomes contaminated at any time during the operation, place another sterile towel over the contaminated site.

SWABS
Ten cm. gauze squares folded and held in sponge forceps are used for swabbing
PACKS Large squares of gauze or linen are used as packs. These packs are placed in cavities so as to keep organs and vital structures out of reach of sharp instruments being used at the operation site.
All these swabs and packs are counted and placed on the sterile trolley
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