For a patient with a prosthetic joint or implanted device at the incision site, how should skin prep be performed?

• A. Ignore device and proceed with standard prep
• B. Use povidone-iodine exclusively around device
• C. Follow device-specific guidelines; maintain sterile technique and avoid contamination of the implant site
• D. Remove implant before prep

Answer: (C)

When a patient has a prosthetic joint or implanted device at the incision site, skin prep must follow device-specific guidelines and keep the entire surgical field sterile around the implant. Implants can serve as a nidus for infection, so prep techniques, antiseptic agents, and application methods are tailored to protect the prosthesis and avoid introducing contaminants into the implant pocket. This means using the recommended antiseptic strategy for devices, applying it in a way that covers the area around the implant, and maintaining strict sterile technique to prevent any contamination of the implant site. Removing the implant or focusing prep only around the device would not address the need for a comprehensive, device-guided approach to infection prevention.