Guidelines For Surgical Skin Prep With Betadine

Health care workers must wear protective gear to keep themselves, and patients, safe.
Health care workers must wear protective gear to keep themselves, and patients, safe. (Image: ready for surgery! image by Laser from

Although there are a few different methods, skin preparation using a betadine solution is still the standard of care for cleansing the skin prior to surgery or medical procedures. Betadine has few risks to the patient when it is used appropriately.


Although the safety of the patient is of utmost importance, health care workers also have a duty to keep themselves protected from potential infection and disease. According to the Centers for Disease Control and Prevention (CDC), “Preventing the transmission of infectious diseases to health care personnel is an important aspect within infection control. CDC recommends preventing such transmissions by incorporating effective prevention methods and exposure management techniques.”

The best way to remain safe is through the use of PPEs, or personal protective equipment. PPEs include gowns, masks, goggles, gloves, etc. The first thing a health care worker should do prior to beginning a surgical scrub is to wash her hands, then put on her gown and gloves. Sometimes, the unexpected happens. If the worker finds that the area to be cleaned is infected, oozing or bleeding, her risk of infection is greatly decreased by having already been prepared.

Positioning and Draping

Depending on the procedure, the patient should be put in the correct position. Medical staff should know the physician’s positioning preference for each surgery. The site to be scrubbed should be exposed, but the rest of the patient should be covered, or draped, to preserve the patient’s dignity.


To completely sterilize the skin, cells would be destroyed beyond repair. Surgeons use betadine prior to a procedure because it is an antiseptic, which leaves the skin clean enough to make surgical procedures safe. Betadine is a rust-colored liquid. It is also known as povidone-iodine, and it reduces the bacteria that can grow on the skin and infect it.

Betadine comes in several forms. It comes in large containers that can be squirted on the skin and spread over the area to be incised. This is called the five-minute, two-step skin prep process. There are also pre-packaged and disposable betadine swabs. The outside of the package is not sterile, but the inside is. A nurse or other assistant holds and opens the packaging, while someone wearing sterile gloves spreads the betadine over the area prior to the surgeon making the first incision.

Side Effects

Betadine is generally safe, although an allergic reaction can occur. During the procedure, medical staff should take care that excess betadine does not pool, or collect, under the patient. If betadine sits on the skin for a long period of time, the skin can become irritated from the chemical or the moisture.

Advising the Patient

Most surgical patients receive a basic set of instructions prior to being discharged. They should be advised to keep the surgical site clean and dry. Betadine keeps the area clean during surgery, but if the area gets dirty or stays wet, it will become infected. The patient should be told how to care for the incision at home. Redness, swelling, bleeding and fever are signs of infection. The patient should know to call the doctor if any of these signs appear.

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