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Pre-Surgery Instructions for Body Cleansing

Getting your skin ready for surgery is extremely important! To do this, one must cleanse your skin with CHG. This is a special

chemical found in soaps such as Hibiclens and other brands. First, purchase the 4% Hibiclens at any pharmacy (Walmart, City Market,

etc). Second, preparation is to gather clean, freshly-laundered washcloths, towels and clothes for each shower. Before using, read all

instructions!

Frequency for bathing must be once a day, for 3 days prior to surgery, & the morning of surgery for the best results!

 Steps for showering or bathing with the CHG/4% Hibiclens : If allergy reactions occur, stop using.

  1. Wash and rinse your hair, face, and body using your normal shampoo and soap.
  2.  Make sure you completely rinse off in a very thorough manner.
  3.  Turn off the shower, or step out of the bathwater.
  4.  Pour a quarter size amount of liquid CHG/Hibiclens soap onto a wet, clean washcloth, and apply to your entire body FROM THE NECK DOWN. Do NOT use on your face, hair, or genital areas.
  5. Rub the soap filled washcloth over your entire body for 3 minutes; apply more soap as needed (1/4 of bottle should be used with each of the 4 showers/cleansing). Avoid scrubbing your skin too hard.
  6. Turn on the shower/return to the bath, & rinse the soap off your body completely with warm water.
  7. Do NOT use regular soap after washing with the Hibiclens.
  8. Pat your skin dry with a freshly-laundered, clean towel after each shower/bath cleansing.
  9. Dress with freshly-laundered clothes after each shower/bath cleansing
  10. It is important the night before  surgery, upon the 3rd  day of bathing, sleep with clean bed linens!
  11. Do NOT apply any lotions, deodorants, powders, or perfumes to your body.
  12. Do NOT shave your legs the night before  or the day of surgery! Nor remove any body hair below the neck. Facial shaving is the only thing permitted before surgery.
  13.  Throughout this process, good hand hygiene is a must throughout the entire day, each day. Wash hands with soap and water for the timeframe it takes to sing “Row, Row your boat” to ensure adequate cleansing.

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PLEASE BRING THIS FORM WITH YOU TO SURGERY CENTER AT ADMISSIONS ON SURGERY DAY

I, the patient, DID complete the following showers/baths Hibiclens Cleansing as instructed:

_____ 3 days before surgery

_____ 2 days before surgery

_____ 1 day before surgery

_____ Morning of surgery

Patient’s Signature:___________________________________________ Date:_____________

*Staff; Please place this page in patient’s chart—by request of Infection Prevention Nurse