Do you really need to remove fingernail polish for surgery?

fingernail polish for surgeryWhy do the preop surgery folks tell us to avoid fingernail polish for surgery? And for that matter, why are we told to avoid eating and drinking after midnight? That one’s easier to explain. When a patient is going to sleep for surgery and the anesthesiologist is putting a breathing tube down your throat, there’s a risk you could vomit. If you recently ate, the vomit could go down into your windpipe and lungs (a process called aspiration). But if you’re fasting before surgery, then there’s nothing in your stomach. Therefore, less risk of aspiration. But what’s up with fingernail polish for surgery?


Why do surgeons hate fingernail polish for surgery?!

One of the least invasive ways to monitor the oxygen level in your blood is with a pulse oximeter. See the photo above. A pulse oximeter, or ‘pulse ox’ for short, lightly clamps onto the finger tip and monitors the level of oxygen in your blood in real time. This is certainly easier than drawing blood from the patient’s artery every time the anesthesiologist wants to check the level of oxygen.


The pulse ox needs clear access to the blood vessels in the fingertip and nail polish can affect the readings. This study set out to assess how these 10 different colors affect pulse ox readings:


“Ten different colors of Wet ‘n’ Wild (Pavion; Nyack-on-the-Hudson, NY) fingernail polish were used: red, yellow, dark blue, green, black, purple, fuchsia, light blue, brown, and white.”


According to the study, black and brown were the only colors to alter the readings to a statistically significant degree. However, even in those circumstances, if the pulse ox was placed on the finger in the ‘side-to-side’ direction rather than the normal ‘top-to-bottom’ direction of the finger, the readings were again accurate.


So next time you go to surgery, you have 3 options:

  1. 1. don’t wear any nail polish.
  2. 2. allow the OR staff to remove your nail polish.
  3. 3. argue with the staff and cite this article and tell them to place the pulse ox in the side-to-side position if you’re wearing black or brown nail polish. Or the top-to-bottom position if wearing any of the other 8 colors above.

I would recommend against the 3rd option. Arguing with OR staff before your operation is bad karma!


Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.


“Dr. Kaplan is a true professional. He gave me extremely helpful and direct honest advice…I strongly recommend him.”– David S.

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