Contraceptive Implants

1
Contraceptive Implants Session VI Infection
Prevention
2
Preparing for Insertion

• Have the client wash her entire arm (one she uses
  less often).
• Cover the procedure table and arm support with a
  clean cloth.
• Ask client to lie on her back so that implant arm
  is turned outwards and bent at the elbow and is
  well supported.
• Prepare clean instrument tray, open sterile
  instrument pack.
• For Jadelle and Sino-Implant (II), carefully open
  sterile pouch containing implants by pulling
  apart, without touching the rods, allowing them
  to fall into a sterile cup or bowl.
• For Implanon, remove the sterile applicator with
  the preloaded implant by allowing it to fall on
  the sterile tray.

3
Before Insertion

• Wash hands with antiseptic soap and water, dry
  with clean towel or air-dry.
• Put sterile or high-level disinfected (HLD)
  gloves on both hands before procedure.
• Clean insertion site with a cotton soaked in
  antiseptic solution and held in a sterile or HLD
  forceps.
• Use sterile surgical drape with a hole to cover
  arm. Hole should be large enough to expose entire
  area where implants will lie.
• When giving local anesthetic, use a new
  disposable syringe and needle, if available, an
  autodisable syringe is preferable.

4
During Insertion Jadelle and Sino-Implant

• To minimize risk of infection and/or expulsion,
  make sure ends of rods nearest to the incision
  are not too close (not less than 5 mm) to
  incision. If tip of rod is too close to the
  incision, it should be carefully removed and
  reinserted. To enable easy removal of both rods
  from a single incision, it is important that ends
  of rods closest to the incision are not farther
  apart, than the width (not length) of one
  implant.
• While inserting implants, try not to remove
  trocar from incision. Keeping trocar in place
  minimizes tissue trauma, decreases chances of
  infection, and minimizes insertion time.

5
During Insertion Implanon

• After confirming rod is in applicator, remove
  needle shield.
• Without needle shield, implant can fall out, so
  keep applicator in upright position until
  insertion.
• If it falls out or if contamination occurs, use a
  new package.

6
After Insertion

• Clean around insertion site with antiseptic.
• Cover insertion site with bandage and cover with
  gauze.
• Dispose of applicator, syringe and needle in
  sharps container. Burn or bury when ¾ full.
• Decontaminate non-disposable instruments in 0.5
  chlorine for 10 minutes.
• Dispose of contaminated items like gauze, cotton,
  etc. in leak-proof container or plastic bag.