Research On The Skin Preparation Methods Of Hand Operation

People cannot perform their daily activities independently without hands,so hand diseases will have a huge impact on patients’ work, study and dailylives.Once surgical site infection happens,it will affect the wound healing, andincrease the suffering of the patients.Preoperative skin preparation is a simpleand convenient nursing measure，which can effectively reduce the operationregion’s bacterial content and bring down the incidence of surgical siteinfections （SSI）[1].Hands have more chances to acquire a large number ofmicroorganisms. Because of the particular anatomical structure of hands，it isdifficult to carry out preoperative skin preparation. So finding the effective skinpreparation method is important for the patients with hands operations.Objective: Compare the three different skin preparation methods for thepatients with hands operation to find out the most effective way for preventingSSI.Methods: According to the inclusion criteria，60patients was selectedfrom China-Japan Union Hospital of Jilin University from July to October in2011. Divide the60patients into three groups. In the day before operation,health education was carried out in three groups，then the nurses examined thepatient’s skin of hands and helped them to manicure nails and removaldirt.Group A and B were respectively carried out hand rubbing and brushingduring one hour before surgery.No treatment was carried out on group C.Sampling for hand bacteria was carried out for the three groups respectivelybefore and after the skin preparation. Compare the difference of elimination of bacterial colony on the surface of skin among the three groups.At the same time,using visual scoring of skin （VSS） form and hand skin assessment （HSA）form to estimate the skin condition of group A and B.Results: After hand rubbing and brushing，the clearances of bacterial ofgroup A and B are higher than group C（P＜0.05）respectively，There is nostatistically significant difference between group A and B（P＞0.05）.According to the result of VSS，there is no statistical difference in the scoresbefore and after skin preparation in group A，while the score after skinpreparation is lower than before skin preparation in group B（P＜0.05）；There is no difference in the scores between group A and B before skinpreparation，while after skin preparation the score of group A is higher thanB（P＜0.05）. The result of HSA shows that there is no statistically significantdifference in feeling、appearance and integrity before and after skin preparationin group A.While after skin preparation the humidity of skin exceed before skinpreparation（P＜0.05）.In group B，the score after skin preparation is lowerthan before skin preparation in the aspects of feeling、 appearance、integrityand humidity（P＜0.05）；There is no statistically significant difference in theaspects of feeling、appearance、integrity and humidity before skin preparationbetween group A and B.The score of group A is higher than B in thefeeling、appearance and humidity after skin preparation（P＜0.05），while there is no statistically significant difference in integrity of skin between beforeand after skin preparation.Conclusion: Through comparing the three different skin preparationmethods for patients，it is found that carrying out hand rubbing and brushingone hour before surgery is better than traditional skin preparation method in theclearance of bacteria. The results demonstrate that hand rubbing will reducediscomfort of skin comparing with brushing.Hand rubbing not only can greatlyreduce the bacterial content to achieve the purpose of skin preparation，but alsoeffectively protect the skin of hand.Therefore，hand rubbing is a simple、effective and safe method of the skin preparation.