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lüll Skin Preparation for Injections: A Review of Clinical Effectiveness, Cost-Effectiveness and GuidelinesDulong C; Brett K; Argaez CSkin Preparation for Injections: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines-/-CADTH Rapid Response Reports 2020[Mar]; ä (ä): äInfection control is a priority for all health care professionals and includes a variety of practices commonly used for patients and the general public. One branch of infection control is skin preparation, also known as alcohol swabbing. This a common technique often involving the application of a disinfectant to the skin prior to a surgical or non-surgical procedures. An example of skin preparation is when health professionals wipe (or swab) an alcohol or other disinfectant solution before they administer an injectable or when withdrawing blood from an individual. Although skin preparation has been widely used and implemented across health organizations, there has been recent debate whether skin preparation before vaccine (or other injectables) administration reduces infection rates for patients. According to the World Health Organization (WHO), injections are unsafe when administered with unsterile or improper technique and it is important to avoid contamination when administering injectables like vaccinations or medication (e.g., insulin). The WHO suggests that the standard practice for skin preparation with regards to vaccination or other injectables is swabbing the injection site with a saturated 60% to 70% alcohol swab for 30 seconds and allowing the area to dry for 30 seconds. A variety of alcohol swabs are available on market including isopropyl or ethanol-based swabs. Alcohol swabs can be costly for health organizations to prioritize in budgets due to a high volume of vaccinations taking place. For instance, vaccination programs can be costly given the number of publicly funded vaccines recommended for Canadian children and adults as these programs not only encompass the administration of vaccines but also staff training, and infection control procedures surrounding vaccine administration, including skin preparation. Various health organizations including the WHO, United Kingdom's Department of Health, and Australia's Department of Health have stated that if the skin is visibly clean, disinfecting the skin (or alcohol swabbing) is not necessary and does not reduce infection. To the contrary, the Public Health Agency of Canada advises the practice of cleaning the skin with a suitable antiseptic solution prior to vaccination or injection. Hence, there is ongoing debate whether the continued use of alcohol swabbing is clinically necessary and effective for routine injections or vaccinations. The purpose of this report is to summarize the evidence regarding the clinical effectiveness and cost-effectiveness of skin preparation prior to injections. Evidence-based guidelines regarding preparing the skin for injection will also be sought.ä |