Nonsterile Tray for Anesthesia

Place the following items on a nonsterile drape covering a Mayo stand:

Nonsterile gloves

1 inch of 4 X 4 gauze soaked with povidone-iodine solution

3-mL syringe filled with 2 percent lidocaine with epinephrine (Xylocaine with epinephrine)

30-gauge needle

Labeled formalin container(s) for the number of biopsies to be performed

Sterile Tray for the Procedure

Place the following items on a sterile drape covering a Mayo stand:

Sterile gloves (Some physicians choose to perform the procedure using the nonsterile gloves that were used to administer the anesthesia.)

Desired punch biopsy instrument (3 or 4 mm)

Needle holder for suturing

Desired size suture (4-0, 5-0 or 6-0 nylon suture, depending on body site)

Iris scissors

21-gauge, 1¼­inch needle for elevating the specimen (Alternatively, the nonsterile anesthesia needle can be used.)

Sterile fenestrated drape (Some physicians choose to perform the procedure without a covering drape.)

Postprocedure Nursing Instructions

Cleanse the area with saline or water if blood or povidone-iodine solution remain on the skin following the procedure. Apply antibiotic ointment and a bandage to the site. The patient can apply pressure to the site if any bleeding is noted.

The anesthesia needles, suture needles and disposable punch biopsy instrument are disposed of in an appropriate sharps container.

The bloody gauze is disposed of in an appropriate biohazard waste container.

The instruments are scrubbed, washed, rinsed and dried. The instruments are placed in a clear sterilization packet, individually or as a surgical tray, and sterilized in the autoclave.

Adapted with permission from Zuber TJ. Office Procedures. Baltimore: Lippincott Williams & Wilkins, 1999.