skin prep, a procedure for cleansing the skin with an antiseptic before surgery or venipuncture. Skin preps are performed to kill bacteria and pathological organisms and to reduce the risk of infection. Various skin prep devices are available for this procedure. Such devices are commonly constructed of plastic, filled with a specific antiseptic, and equipped with an applicator. The antiseptic is applied by rubbing the device in a circular motion over the skin. Some of the most common antiseptics contained in skin prep devices are iodine, povidone-iodine, and ethyl alcohol. Each antiseptic has associated advantages and disadvantages. The iodine skin prep kills bacteria, fungi, viruses, protozoa, and yeasts and is an inexpensive and reliable device. The disadvantages of iodine, in addition to its discoloring of the skin, are that it may burn or chap and may cause an allergic reaction. Povidone-iodine, which consists of water-soluble complexes of iodine and organic compounds, is less irritating than iodine tinctures or solutions and does not stain the skin as much as iodine. However, povidone-iodine is less effective than regular iodine solutions, may be absorbed through the skin during prolonged use, and may cause an allergic reaction. Ethyl alcohol, which is not effective against spore-forming organisms, viruses, and tubercle bacilli, is effective as a fat solvent and a germicidal when used in concentrations of 70% to 80% and may be used as a substitute skin prep antiseptic when the patient is allergic to iodine. Some disadvantages of ethyl alcohol are that it evaporates quickly, is highly flammable, and dries the skin excessively. Most skin prep devices are prepackaged and are disposable items for one-time use. To prep the skin with such a device before a venipuncture, the device is moved in a circular motion with the applicator rubbing the skin at the intended venipuncture site. The venipuncture site is swabbed with the antiseptic for about 1 minute. The antiseptic is spread over an area about 2 inches (5.08 cm) in diameter with the venipuncture site at the center.
