Spray or wipe disinfection in skin antisepsis

Punctures and injections, which rank among the most frequent invasive measures in health care, penetrate the skin’s natural protective measure, allowing microorganisms on the skin to enter deeper skin layers and trigger abscesses and sepsis there. Consistent skin antisepsis before such procedures reduces the risk of infection. The Robert Koch-Institute (RKI) recommends [1] the following:

Preparation:

• Wear short-sleeved clothes, if clothing protocols allow.
• Carry out hygienic hand disinfection before every puncture.
• Immediately prior to the puncture: carry out skin antisepsis; pay attention to the exposure time.

The skin antiseptic can be applied by a soaked swab or by spraying.

• When using a swab (wipe disinfection): the type of swab depends on the situation-specific risk of infection. Basing on risk assessment, a hygiene plan should specify which swabs are to be used, for example, low-germ swabs for subcutaneous injections by medical staff or peripheral intravenous injections, or sterile swabs for diagnostic spinal punctures, organ punctures, amniocentesis, chorionic villus sampling.
• When spraying the skin antiseptic: skin antisepsis should be carried out near the skin. To ensure optimal spread of the skin antiseptic spray from a distance of approx. 5 cm.
• Independent of the procedure, always pay attention to the manufacturer’s information on exposure times.

Sources:

1. KRINKO (2011) Anforderungen an die Hygiene bei Punktionen und Injektionen. Bundesgesundheitsbl 54: 1135–1144.