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Waiting for the Prep to Dry - Why Dry Times Matter

According to the American College of Surgeons, nearly 100 operating room (OR) fires occur annually in the United States. That’s 100 too many.


Remember, a fire requires three elements: an ignition source, an oxygen source, and a fuel source. Among these, alcohol-based prep solutions are a common and potent fuel source.


So, how can we reduce this risk? One crucial step is adhering to the recommended dry time rule for alcohol prep solutions.


Many alcohol-based prep solutions are over 70% alcohol, with the remainder typically being an antimicrobial agent. These solutions are widely used in surgical settings, and it’s essential for OR professionals to follow the manufacturer’s Instructions for Use (IFU) when using these products. The IFU specifies how long an alcohol-based prep must dry before draping begins. And while most of us are used to using three minutes as the standard for dry times, always confirm with the IFU of the product that you are using.


But, why do we have a dry time?

The dry time ensures the solution fully evaporates, eliminating any residual liquid on the patient, dissipating alcohol vapors that could become trapped under surgical drapes and evaporating pooled solution. By addressing the risks associated with the fuel source, we can reduce the likelihood of surgical fires.


We all know that time is a precious commodity in the OR. To a surgeon, thirty seconds might feel like a lifetime, so three minutes can seem like an eternity. Surgeons may even suggest skipping the wait. But at the end of the day, protecting and advocating for the patient - who cannot speak up for themselves during surgery - must remain our top priority. Preventing surgical fires is part of that responsibility., and three minutes is a small price to pay when compared to the potentially life-altering consequences for a patient harmed by a preventable fire.


Dry Time Reduces Infection Risks, Too

In addition to fire prevention, allowing alcohol-based preps to dry fully also helps reduce the risk of surgical site infections (SSIs). When the prep is allowed to dry completely, the patient’s skin is properly disinfected before the first incision, significantly lowering the chance of post-operative infections.


Alcohol-based preps are among the most effective, affordable, and widely available options for skin preparation in the OR. However, improper use can turn these advantages into risks. While correct application is crucial, allowing the solution to dry is just as important in ensuring patient safety.


Revisiting the "Why" in the OR

This season, we’re diving into the "why" behind many OR practices. Perhaps it will remind you of the days when you were a new OR nurse, asking questions to understand the reasoning behind protocols. Or maybe it will encourage you to pause and reconsider cutting corners for the sake of speed. Following procedures "by the book" isn’t about bureaucracy - it’s about protecting our patients.


As we explore evidence-based answers to various questions this season, we hope to reinforce the importance of small but significant steps, like waiting the appropriate amount of time for the alcohol-based prep to dry. And while we'll be discussing many of the reasons why we do what we do, and evaluating the evidence to support our actions, it ultimately comes down to this: patient safety is our top priority, and we can help to ensure safe surgical outcomes when we let protecting our patients guide our actions in the operating room.


Lindsey


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