Abstract:
A device used for applying an antiseptic preparation to a surgical site of a patient prior to surgery outside of an operating theater. A loose-fitting bag is provided which encloses the surgical site by securing the open end(s) to the patient by closing means. A high friction scrub surface is provided in the bag. A method and apparatus are also provided for releasing antiseptic into the interior of the bag. The method provides that the surgical site can be scrubbed within the bag so as to properly prepare the skin for surgery. A temperature indicator for the antiseptic preparation is also provided.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation in part of U.S. application Ser. No. 11/602,542 filed Nov. 21, 2006 now U.S. Pat. No. 8,403,898. 
    
    
     FIELD OF THE INVENTION 
     This present invention relates to a method to an apparatus and method for applying antiseptic prior to surgery. 
     BACKGROUND OF THE INVENTION 
     Surgical site infections are frequently caused by bacteria commonly found on the surface of the skin. Since 1867, when Joseph Lister discovered the link between microbes and patient mortality after operations, he coined the term “antiseptic” after discovering that certain surgical preparations could be applied before surgery to eliminate bacteria. Practitioners have used aseptic techniques to reduce post-operative infections ever since. 
     In order to reduce bacteria, antiseptics are used prior to conducting the surgery to clean and disinfect the surgical site. Types of antiseptics include alcohols, iodine or iodine-containing compounds and chlorhexidine gluconate among others. There are two primary types of iodine-containing compounds, tincture of iodine, and iodophors. Tincture of iodine is an alcohol solution and was one of the first antiseptics used. However, iodophors are more commonly used today to prepare a surgical site for surgery. 
     The most common aseptic technique for sterilizing a surgical site requires application of an antiseptic solution immediately prior to the surgical procedure in the sterile operating theater after the patient has been anesthetized. When performing surgery to the extremities, i.e., leg or arm, the entire extremity is typically cleaned with the antiseptic solution. A sponge is immersed in the antiseptic solution, then applied to an area of the extremity with a scrubbing action and then discarded. A new sponge is immersed into the antiseptic solution and applied to a different area of the extremity. This process is then repeated until the entire area has been scrubbed. The scrubbing action physically dislodges bacterial colonies. Once the scrubbing is completed, another antiseptic solution is reapplied with a sponge in a painting action using a new sponge with each repeated application. After this procedure the surgical personnel must wait at least five to seven minutes before beginning the surgical procedure. The delay is required to allow the antiseptic solution to disinfect the surgical site. 
     There are several problems with the prior art procedure for disinfecting a surgical site. During the application of the antiseptic solution to the extremity, numerous sponges are required to be used and discarded, thus creating waste that must be handled and properly discarded. There is also a possibility that the surgical site will not be completely covered, thus creating a potential for bacteria and other contaminants remaining during surgery and serving as a potential source for post-surgical infection. The application of the antiseptic solution is prone to splashing and uncontrolled spills. Excess antiseptic solution spills creating a potential safety hazard and a potential for infection. 
     The prior art procedure for applying the antiseptic solution is also costly and time consuming. Operating theaters are expensive to maintain and operate. The time that the antiseptic solution takes to be effective costs the patient and the hospital a significant amount of money. The delay also slows the throughput of the operating theater, thereby raising the cost of the procedure to the hospital and the operating staff. 
     The prior art procedure puts the patient at an increased risk of morbidity and mortality by increasing the amount of time the patient is under anesthesia. 
     The current invention provides a device and method for applying an antiseptic solution to a surgical site prior to surgery, but outside the operating theater thus reducing anesthesia time along with operating room time and cost. The invention also contains the spills and reduces waste. Since the application of the antiseptic can be accomplished outside the operating theater, additional time and care can be used in applying the antiseptic, thereby reducing post-surgical infection. 
     Various prior art devices and methods have been used in the past to cover a wound, protect a wound site, or apply medicine to a wound site. But none of the prior art has been used to streamline application of a surgical antiseptic prior to surgery. 
     For example, U.S. Pat. No. 2,661,739 to Caskey discloses a casing which is made from elastic material to fit against an extremity to hold an absorbent material against a wound. The casing is surrounded by a fabric jacket to hold the casing and absorbent material in place and exclude contamination from the environment. However, the casing is only disclosed to be used after a wound has occurred and it does not disclose using the device to pre-treat an area prior to surgery. Additionally, it does not allow for the scrubbing of medicine against the skin through the device. 
     U.S. Pat. No. 6,992,233 to Drake, et al. discloses a delivery system for a flowable medicine to a wound in a confined area. Flowable medicine is contained in a strip which is adhesively applied to the skin such that the medicine is delivered to the wound. The flowable medicine is released when removable seal is removed. Drake does not disclose using the device for application of medicine prior to a wound occurring or to a large area of the body. It is limited to the area covered by the strip. Drake also does not disclose scrubbing the medicine against the skin through the device. 
     U.S. Pat. No. 6,664,434 to Cominsky discloses using a sealed bag around a wound to contain bodily fluids. The device includes an absorbent layer to absorb the bodily fluids exuding from a wound. It does not disclose using the bag prior to the wound or introduction of an antiseptic fluid within the bag. It also does not disclose the scrubbing of an antiseptic through the device. 
     The prior art fails to disclose or suggest a surgical solution application for preparing a patient&#39;s skin prior to surgery. Therefore, it is desirable to have a device and method for facilitating application of antiseptic solution in a non-sterile environment. 
     SUMMARY OF THE INVENTION 
     A surgical preparation solution applicator is described for preparing a patient&#39;s skin for surgery prior to entering the surgical theater. More specifically, a device and method for facilitating application of antiseptic solution to a surgical site in a non-sterile environment is described. 
     The applicator, in one embodiment, includes a bag which is sealed on three sides and open on a fourth side. A resilient seal gasket is affixed to the open end of the applicator bag. The gasket fits snuggly around the patient&#39;s body forming a seal between the interior of the bag and patient&#39;s body. An antiseptic solution is then introduced into the application bag through either a port in the application bag, a solution deployment pouch within the application bag or through an opening between the gasket and the patient&#39;s body. The gasket prevents the release of the antiseptic until removed. 
     The solution deployment pouch releases antiseptic into the bag once the gasket is secured. The pouch can take the form of a capsule in ducted communication with the application bag which is filled with the antiseptic solution. Other embodiments include one or more ports and/or one or more solution deployment pouches. 
     In another embodiment, the applicator bag employs other closing means to seal the open end of the application bag securely against the patient&#39;s body. This closing means can include but is not limited to a pressure inflatable cuff, a tourniquet, or a pressure strap fixed with a buckle or Velcro® closure. 
     In another embodiment, the application bag is open on two ends having a resilient seal gasket fixed at each end. In this embodiment, the patient&#39;s body is inserted through the seal gaskets at both open ends of the application bag. 
     In another embodiment, the application bag is suited well for use on a relatively flat area of the body, such as the back or abdomen. In this embodiment, the open end of the bag is secured to the patient with a disk-like adhesive strip. The adhesive strip temporarily adheres to the patient&#39;s body during the procedure and acts as a seal between the patient&#39;s body and the interior of the bag. After the adhesive is adhered to the patient&#39;s body, the antiseptic solution is released inside the application bag, either through a port or by a solution deployment pouch located inside the application bag. 
     At all places other than the seal gasket, the application bag is loose-fitting around the patient&#39;s body to allow the user to manipulate the bag freely and completely apply antiseptic around the body part being treated without breaking the seal of the gasket. 
     In the preferred embodiment, the application bag is used to disinfect the surgical site before the patient has undergone use of anesthesia. Because the patient is awake, the temperature of the antiseptic solution may be uncomfortable to the patient and increase surgery anxiety in the patient. For this reason, the invention further provides an inexpensive mechanism to monitor the temperature of the antiseptic solution prior to application to the patient. Matching the temperature of the antiseptic solution to the patient aids in reducing pre-surgery anxiety of the patient and therefore a more efficient application of the antiseptic solution. 
     In yet another preferred embodiment, sterile sponges or other devices used to apply the antiseptic solution to the body can be contained in sealed pouches secured to the inside of the application bag or inside the antiseptic pouch. When the antiseptic is deployed within the bag, the sterile sponges are used to apply the bag and then discarded with the bag prior to surgery. 
     After this process has been completed, the application bag contains the antiseptic and prevents outside bacteria and contaminants from contacting the treated area. The application bag is designed to remain in place until the patient is positioned in the operating theater. The application bag is removed immediately prior to surgery. 
     In another embodiment, the application bag is suited well for use on an extremity, preferably a leg. In this embodiment, the application bag is generally shaped to fit around the extremity. The application bag is secured to the extremity with any of, but not limited to, the aforementioned securing means. The application bag further has a plurality of holes, preferably at the anterior knee area and both sides of the ankle to accommodate the attachment of a scrub brush. The application bag has an antiseptic insertion means that includes, but is not limited to, the aforementioned antiseptic means. 
     The scrub brush comprises a brush and a collapsible handle connected to the brush. The brush includes bristles attached to a scrubbing surface. The brush is attached to the inside surface of the application bag at one of the plurality of holes. The collapsible handle is connected to the brush protruding through the application bag allowing a user to move the scrub brush without the user contacting the patient&#39;s skin. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In the detailed description of the preferred embodiments presented below, reference is made to the accompanying drawings. 
         FIG. 1A  is a perspective view of an embodiment of the invention showing the use of a flat neoprene gasket seal. 
         FIG. 1B  is a cross sectional view of a preferred embodiment of fill/drain port. 
         FIG. 2  is a perspective view of a preferred embodiment of the invention showing an alternate closing means. 
         FIG. 3A  is cross sectional view of a preferred embodiment of an antiseptic pouch attached to the interior of the application bag. 
         FIG. 3B  is a cross sectional view of a preferred embodiment of the invention showing an antiseptic capsule attached to the interior of the application bag. 
         FIG. 3C  is a perspective view of a puncturing device used in a preferred embodiment of the invention. 
         FIG. 4  is a perspective view of a preferred embodiment of the invention showing an alternate closing means. 
         FIG. 5  is a perspective view of a preferred embodiment of the invention disclosed. 
         FIG. 6  is a perspective view of a preferred embodiment of the invention showing the use of two closing means. 
         FIG. 7  is a perspective view of a preferred embodiment of the invention showing two closing means. 
         FIG. 8  is a plane view a preferred embodiment of the invention. 
         FIG. 9  is a side view of a preferred embodiment of the invention. 
         FIG. 10A  is a side view of a preferred embodiment. 
         FIG. 10B  is an end view of a preferred embodiment. 
         FIG. 10C  is a partial section view of a preferred embodiment. 
         FIG. 10D  is a detail top view of a preferred embodiment. 
         FIG. 11A  is a perspective view of a scrub brush of a preferred embodiment of the invention. 
         FIG. 11B  is a side view of a scrub brush of a preferred embodiment of the invention. 
         FIG. 11C  is a detail view of a connection means of a scrub brush of a preferred embodiment of the invention. 
         FIG. 11D  is an end view of a scrub brush of a preferred embodiment of the invention. 
     
    
    
     DETAILED DESCRIPTION 
       FIG. 1A  shows a preferred embodiment of solution applicator  100 . Solution applicator  100  includes application bag  110 . In the preferred embodiment, application bag  110  is made of HDPE (high density polyethylene) which is typically translucent, but not fully transparent. In other embodiments, the application bag can be made out of LDPE (low density polyethylene) and can be quite clear, but still not totally transparent. In other embodiments, LLDP (linear low density polyethylene) can be employed where a higher structural rigidity is required by the cleaning process. Other flexible sheeting can be used so long as it is inert with respect to the antiseptic solution. 
     In another preferred embodiment, the interior and/or exterior of the application bag can be textured to increase the effectiveness of the application of the antiseptic to the patient. If on the exterior of the application bag, the purpose of the texturing is to increase friction between the hands of the user and the exterior of the application bag to aid in manipulation of the application bag during use. If on the interior of the application bag, the textured surface is useful in scrubbing the surgical site to remove bacterial colonies. Examples of textures can include raised ribs, chevron patterns, diamond patterns or random “crinkling.” Other plastics can be used if complete transparency is required for various cleaning processes. In other embodiments, the application bag can be color coded to indicate different sizes, different antiseptics contained within the bag or the proper operating theater for the patient. 
     In a preferred embodiment, application bag  110  can be formed from two identical or nearly-identical sized sheets. Both sheets will have the same or nearly the same shape. In a preferred embodiment, the two sheets are rectangular. All of the sides but one are sealed or fused by an adhesive or heat welding as known in the art, leaving the remaining side open. The flat format of the completed application bag increases the ease of storage and/or deployment of the bag from a roll or cardboard box as known in the art. The shape also promotes economy of manufacture. 
     In another preferred embodiment, application bag  110  can be formed by a flexible tubular extrusion of plastic. After manufacture, the tube can then be cut to length. After being cut, one end is sealed or fused by known inductive welding means leaving the other end open. Other preferred embodiments can include frustroconical shapes, inverted frustroconical shapes and generally spherical shapes. 
     Different parts of the body can be decontaminated. In  FIG. 1A , patient&#39;s appendage  150  is shown surrounded by solution applicator  100 . The dimensions of the application bag vary depending on the part of the body being decontaminated. Application bag  110  should fit loosely around the body part placed inside application bag  110 . 
     In the preferred embodiment, the general circumference of application bag  110  is at least 2 inches larger than the part of the body being decontaminated. The width of application bag  110  in a preferred embodiment is usually between 2 inches and 40 inches. In the preferred embodiment, the general length of the application bag is at least 2 inches longer than the part of the body being placed in application bag  110 . The length of application bag  110  in a preferred embodiment would be between 2 inches and 60 inches. The application bag should also allow for complete articulation of any joint surrounded in order to allow for complete coverage by the antiseptic solution. 
     In a preferred embodiment, application bag  110  also includes fill/drain port  140 . Fill/drain port  140  allows for deployment of the antiseptic solution into the application bag and draining of excess antiseptic from the application bag. Fill/drain port  140  is located generally in a position to allow for deployment of the antiseptic solution to cover the extremity.  FIG. 1A  is an expanded view of a preferred embodiment of fill/drain port  140 . Fill/drain port  140  includes lid  180 . Lid  180  seals opening in application bag  110 . Lid  180  includes four parts, cap  188 , threaded section  185 , flexible gasket  182  and port ring  170 . Cap  188  is of such minimum height that it can be easily grasped to open fill/drain port  140 . Threaded section  185  width can vary in size between ¼ inch and 4 inches. Threaded section  185  is threaded to match port ring  170 . 
     Port ring  170  is attached to opening in application bag  110  by a known adhesive or heat welding. Port ring  170  is threaded to receive threaded section  185 . Port ring  170  is approximately the same depth as the threaded section  185 . In the preferred embodiment the depth is between about ¼ of an inch to about 3 inches. A flexible gasket  182  is provided to seal the lid against the port ring. When lid  180  is threaded into port ring  170 , bottom of lid  180  fits flush and seals against of port ring  170 . 
     Fill/drain port  140  can be constructed from any commercially available plastic, including but not limited to polypropylene, polyethylene, or polystyrene. In other embodiments, the fill/drain port can be fitted with a quick release mechanism for removal of the antiseptic with a pump through a hose and connection fitting. Other non-threaded resealable cap and base configurations will also suffice. 
     Attached to open end of application bag  110  is gasket  120 . Open end of application bag  110  is affixed to gasket  120  through a known adhesive or heat welding. Gasket  120  can be manufactured from synthetic rubber, such as neoprene, or a resilient plastic polymer. The gasket color can be coded to indicate the size and/or shape of the bag making for easy and error free deployment of the antiseptic solution. 
     Gasket  120  has hole  130  in the relative center of gasket  120 . Patient&#39;s appendage  150  is inserted through hole  130  and into application bag  110 . In the preferred embodiment, diameter of hole  130  ranges between about 1 inch and 15 inches. However, those skilled in the art will recognize that other sizes can be provided to accommodate different patients and circumstances. Hole  130  should fit around the body extremity such as to prevent the antiseptic solution from escaping application bag  110  when in use. 
       FIG. 2  shows another preferred embodiment of solution applicator  200 . Solution applicator  200  includes application bag  210  which has larger dimensions to accommodate a larger appendage such as a leg. Patient&#39;s appendage  240  is inserted into application bag  210  through opening  215  toward closed end  213 . This embodiment includes solution deployment pouch  220  and a different closing means. 
     Application bag  210  is secured around patient&#39;s appendage  240  through the use of closing means  230 . Some examples of closing means include an elastic band, adhesive tape or strap with a buckle or Velcro® closure. A preferred embodiment includes strap with a Velcro® closure. Closing means  230  allows for securing and searing application bag  210  around varying size appendages and easy adjustment. Velcro® closure includes hook section  260  and receiver section  250  as necessary to use the closing means  230  as described. 
     Closing means  230  is located below the opening  215  of application bag  210  but above the area to be treated with antiseptic, such that the area to be treated with antiseptic is contained within application bag  210 . Closing means  230  can be attached to application bag  210  by commercially available adhesive or can be detachable. 
     Solution deployment pouch  220  is located on the interior of application bag  210  and contains the antiseptic to be deployed. Solution deployment pouch  220  can vary in size and shape depending on the amount of antiseptic solution contained. In the preferred embodiment, the solution deployment bag contains 2.5 liters of antiseptic solution. The solution deployment pouch may be color coded to indicate the type of antiseptic contained or may be metalized to prevent light from entering the pouch to the detriment of the antiseptic solution. In the preferred embodiment, the antiseptic to be deployed is chlorhexidine, sold under the trademark ChloraPrep® and available from Medi-Flex, Inc. of Leawood, Kans. However, other antiseptics that are effective without evaporation can also be employed. 
       FIG. 3A  and  FIG. 3B  illustrate two preferred embodiments for solution deployment pouch  220 . As shown in  FIG. 3A , a cavity  305  is created on the inside of application bag  300  by use of a cavity cover  310 . The cavity cover  310  in the preferred embodiment is a hemispherical flexible container heat welded around its circumference to the interior of the application bag. The size of cavity cover  310  will depend on the amount of antiseptic solution  320  to be contained. Cavity cover  310  is of such strength that cavity cover  310  can be ruptured for use but not during normal handling and storage of the application bag. Cavity cover  310  in the preferred embodiment is formed from a 3 ml plastic sheet made of HDPE. When cavity cover  310  is ruptured, antiseptic solution  320  located in the deployment pouch is released to the interior of the application bag. 
       FIG. 3B  shows another preferred embodiment of solution deployment pouch  220 . Antiseptic solution  320  is encapsulated in capsule  330 . Size and shape of capsule  330  will vary depending on the amount of antiseptic solution  320  contained. Capsule cover  340  forms the outer casing of capsule  330  and encapsulates antiseptic solution  320 . Capsule  330 , and the encapsulated antiseptic  320 , are attached to the inside of application bag  300  by a known adhesive or spot welding. Capsule covering  340  can be manufactured from commercially available plastics. In the preferred embodiment, the covering is HDPE and is about 3 ml thick. In another embodiment, the capsule can be a rigid but fractural plastic capsule contained in a cylindrical form capable of being broken for use through a set of central perforations. Capsule  330  can be attached to application bag  300  at the time of shipment to the user or could be sent separate from the application bag  300  and the user attaches capsule  330  at the time of use. 
     Multiple capsules or pouches can be used in a single application bag depending on the decontamination method being addressed. Further, differing antiseptic solutions can be contained in different capsules. Furthermore, sterile sponges, brushes and swabs can be contained in the capsule at the time of manufacture for use within the application bag to scrub the surgical site. 
     Referring now to  FIG. 3C , a puncturing device is shown used in the preferred embodiment of the invention which allows for easy puncturing of the deployment pouch and/or temperature monitoring. The surface of the deployment pouch is shown as  350 . Fixed to the external surface of deployment pouch  350  is a rigid plastic rectangle  352 . In the preferred embodiment, the dimensions of the plastic rectangle are approximately 10 ml thick and formed of a rigid polystyrene. Other rigid plastics or light metals such as aluminum can be used as well. Plastic rectangle  352  includes halves  360  and  365  separated by a perforation  370 . Perforation  370  in the preferred embodiment traverses the rectangle in an angled fashion, including two pointed extensions  375  and  377 . 
     In use, plastic rectangle  352  is broken along perforation  370  separating the two halves  360  and  365 . Pointed extensions  377  and  375  are then available to breach the surface of deployment pouch  350  thereby allowing the antiseptic fluid contained to escape into the application bag. The advantage of the use of plastic rectangle  352  is to allow controlled dispersion of the antiseptic fluid and to allow a thicker and more robust flexible plastic to be used for the deployment pouch. 
     In yet another embodiment, plastic rectangle  352  can include a temperature sensitive dye. The temperature sensitive dye can be used to indicate the temperature of the antiseptic contained in the deployment pouch to allow for an accurate and effective dispensing temperature or for patient comfort. 
       FIG. 4  shows yet another preferred embodiment of invention. Solution applicator  400  is application bag  410  with one end sealed and one end open. Patient&#39;s appendage  495  is placed inside application bag  410  through the open end. 
     In this embodiment, application bag  410  is closed around patient&#39;s appendage  495  by use of pressure inflatable cuff  430 . Pressure inflatable cuff  430  can be secured by any appropriate closing means  450  and  460 . Specifically, a preferred embodiment for such closing means  450  and  460  is Velcro®, wherein closing means  450  is hook section and closing means  460  is receiver section. Pressure inflatable cuff  430  is located adjacent the open end of application bag  410 . Pressure pump  480  inflates pressure inflatable cuff  430  through tube  490 . Pressure pump  480  can be manually or mechanically inflated. Pressure inflatable cuff  430  when inflated creates a seal sufficient to prevent the antiseptic from escaping application bag  400 . 
       FIG. 5  illustrates solution applicator  400  when pressure inflatable cuff is inflated. 
       FIG. 6  shows yet another preferred embodiment of solution applicator  600 . This embodiment can be employed when only a section of a patient&#39;s appendage  650  is to be treated with antiseptic. In this embodiment, application bag  620  is open at both ends  652  and  654  and is tubular. The length of application bag  620  can vary depending on the size of the area being treated. 
     Each end of application bag  620  is closed around patient&#39;s appendage  650  by use of closing means  630  and  632 . Each closing means is similar to those embodiments already described. For example, if Velcro® is used to secure closing means  630  and  632 , Velcro® closure includes hook sections  640  and receiver sections  610  as necessary to use the closing means  630  and  632  as described. Solution deployment pouch  220  is adhered to the inside of application bag  620  between the closing means on either end. 
       FIG. 7  illustrates solution applicator  600  after each end of application bag  620  has been closed around patient&#39;s appendage  650 . The portion of application bag  620  between closing means is loose-fitting around patient&#39;s appendage  650 . Solution deployment pouch  220  is ruptured and antiseptic fluid escapes to be massaged into the skin. All excess antiseptic is retained in the application bag  620  until closing means  630  and  632  are released and application bag  620  is removed. 
       FIG. 8  shows a preferred embodiment of solution applicator  800 . Solution applicator  800  can be used to apply antiseptic to a relatively flat area of the body, such as the abdomen or back. Application bag  810  forms a generally hemispherical shape placed over the surgical site. In the preferred embodiment, application bag  810  allows a clearance of about 3 inches when attached to the patient. 
     The circumference of application bag  810  is lined with a disk-like adhesive strip  815 . The adhesive strip is of sufficient tackiness to adhere to form a seal with the patient&#39;s skin, but still removable without injury. Suitable adhesives are well known in the art. The width of the adhesive strip should range between ¼ inch and 1 inch. In the preferred embodiment, a removable waxed tape covers the adhesive strip until such time as solution applicator will be applied to patient. Attached to the interior of application bag  810  is solution deployment pouch  220  which contains antiseptic for treatment of the patient. Deployment and use of the antiseptic fluid is similar to that described above. 
       FIG. 9  illustrates a side view of solution applicator  800  attached to abdomen of patient  850 . After adhesive strip  840  is applied to the skin of the patient, the remainder of application bag  810  allows for user to maneuver application bag  810  to rub or massage the antiseptic fluid into the skin without removing adhesive strip  840  from the skin. 
     Referring to  FIGS. 10A ,  10 B,  10 C, and  10 D, application bag  910  has outside surface  914  and inside surface  915 . Application bag  910  further has a plurality of holes  911 ,  912 , and  913 , to accommodate the attachment of a plurality of scrub brushes  900 . Hole  911  is located generally at the anterior knee area. Holes  912  and  913  are located on opposite sides of the ankle area. Scrub brush  900  is attached to inside surface  915  by an adhesive or welding means known in the art. Handle  902  then protrudes through the holes  911 ,  912 , and  913 , extending past outside surface  914  to allow a user to move scrub brush  900  to scrub the patient&#39;s skin without the user making contact with the patient&#39;s skin. 
     Referring to  FIG. 10A , application bag  910  can include a multitude of sealing means including one of, but not limited to, the aforementioned gasket  120  with hole  130 , closing means  230  with hook section  260  and receiver section  250 , and elastic band  720 . 
     Application bag  910  can include a multitude of antiseptic insertion means including one of, but not limited to, the aforementioned fill/drain port  140 , solution pouch  220  including cavity  305  and capsule  330 , and plastic rectangle  352 . 
     In a preferred embodiment, application bag  910  is shaped to generally match leg  960 . In this embodiment, scrub brushes  900  are attached to application bag  910  at the anterior knee area and opposite sides&#39; of the ankle. However, those skilled in the art will appreciate that application bag  910  can be made in a multitude of shapes to generally match other extremities or adapted to fit a torso and scrub brushes  900  can be attached to application bag  910  at any desired location. 
     In a preferred embodiment, application bag  910  is made of HDPE (high density polyethylene) which is typically translucent, but not fully transparent. In other embodiments, the application bag can be made out of LDPE (low density polyethylene) and can be quite clear, but still not totally transparent. In other embodiments, LLDP (linear low density polyethylene) can be employed where a higher structural rigidity is required by the cleaning process. Other flexible sheeting can be used so long as it is inert with respect to the antiseptic solution. Other plastics can be used if complete transparency is required for various cleaning processes. In other embodiments, the application bag can be color coded to indicate different sizes, different antiseptics contained within the bag or the proper operating theater for the patient. 
     In a preferred embodiment, application bag  910  can be formed from two identical or nearly-identical sized sheets. Both sheets will have the same or nearly the same shape. All of the sides but one are sealed or fused by an adhesive or heat welding as known in the art, leaving the remaining side open. The flat format of the completed application bag increases the ease of storage and/or deployment of the bag from a cardboard box as known in the art. The shape also promotes economy of manufacture. 
     In another preferred embodiment, application bag  910  can be formed by a flexible tubular extrusion of plastic. After manufacture, the tube can then be cut to shape. After being cut, ends are sealed or fused by known inductive welding means leaving one end open. 
     In a preferred embodiment, the general circumference of application bag  910  is at least 2 inches larger than the part of the body being decontaminated. The width of application bag  910  in a preferred embodiment is usually between 2 inches and 40 inches. In the preferred embodiment, the general length of the application bag is at least 2 inches longer than the part of the body being placed in application bag  910 . The length of application bag  910  in a preferred embodiment would be between 2 inches and 60 inches. Application bag  910  should also allow for complete articulation of any joint surrounded in order to allow for complete coverage by the antiseptic solution. 
     Referring to  FIGS. 11A ,  11 B,  11 C, and  11 D, a preferred embodiment of scrub brush  900  comprises brush  901 , and rotatable handle  902 . Brush  901  includes bristles  903 , which are attached to brush  901 . Handle  902  is connected to brush  901  at connection brackets  904 ,  905 ,  906 , and  907 . Pins  908  and  909  are inserted into connection bracket  904  and  906  sliding through handle  902  into connection brackets  905  and  907 . 
     Handle  902  can rotate about an axis adjacent to brush  901 . Handle  902  can be moved from position  950 , which is generally perpendicular to brush  901 . Handle  902  can be moved in either direction  951  to rest on brush  901  at position  953 , which is adjacent to brush  901 . Alternatively, brush  902  can be moved in direction  952  to position  954 , which is adjacent to brush  901 . 
     In a preferred embodiment, brush  901  and handle  902  are constructed of a transparent plastic. Bristles  903  are also constructed of a flexible plastic. It will be appreciated by those skilled in the art that a multitude of transparent and durable materials may be substituted for the construction of scrub brush  900  so long as it is inert with respect to the antiseptic solution. 
     In a preferred embodiment, scrub brush  900  is attached to application bag  910  in each of holes  911 ,  912  and  913  with an adhesive or welding means known in the art. The adhesive is applied to form a seal around each scrub brush and each hole. 
     In use, application bag  910  including an antiseptic insertion means is raised to a temperature approximately equal to that of the patient. An indication of the proper temperature is shown by the color of the plastic rectangle included on the deployment pouch. The application bag is extended and placed around the surgical site. In a preferred embodiment, application bag  910  is secured around the proximal end of the extremity. The distal end of the extremity resides in the interior of the application bag. 
     The antiseptic is introduced into application bag  910  through antiseptic insertion means  140 ,  220 , or  352 . The exterior of the application bag is then manipulated to assure coverage of the appendage by the antiseptic fluid. The antiseptic fluid is then rubbed or massaged into the skin through application bag  910  to dislodge biological communities. Scrub brush  900  is manipulated to scrub the skin to dislodge bacterial colonies. Excess antiseptic fluid is retained by application bag  910 . Since application bag  910  is transparent or substantially transparent, a visual examination of the extremity is conducted to assure that adequate and complete coverage of the surgical site has been made. 
     Upon removal of application bag  910 , care must be taken to ensure that any portion of the non-sterile exterior of application bag  910  does not come into contact with the now sterile extremity of the patient. To accomplish removal without contact, gasket  120 , closing means  230 , or elastic band  720  is rolled back so that only its sterile interior is adjacent the extremity. Application bag  910  is then removed by sliding it off of the extremity, making sure that the rolled back edge is the only point of contact. 
     Those skilled in the art will recognize that a more complete application of antiseptic fluid can be made due to the fact that application takes place outside the operating theater. Those skilled in the art will also recognize that the antiseptic can be retained on the surgical area longer, promoting a more thorough decontamination. Those skilled in the art will also recognize that since the decontamination can take place outside the operating theater that substantial operating theater time can be saved with resulting monetary savings to the patient and the hospital. 
     The embodiments have been described in detail with particular reference to certain preferred embodiments thereof, but it will be understood that variations and modifications can be effected within the scope of the embodiments, especially to those skilled in the art.