Scrubbing, Gowning, and Gloving for Surgery

Introduction

• Purpose: Reduce resident bacterial flora on hands; not to make them sterile.
• Importance: Avoid excoriating skin to prevent bacterial growth.

Scrubbing Techniques

General Guidelines

• Duration: 5-minute scrub.
• Motion: Move from clean (fingertips) to dirty (elbows).
• Rinsing & Drying: Follow the same clean-to-dirty principle.
• Avoid: Touching surfaces, especially faucets; restart if contact occurs.

Detailed Scrub Process

• Fingers: Divide into 4 surfaces (lateral, inside, outside, front, back) - 20 strokes each.
• Palm & Hand: Similarly divided and scrubbed.
• Forearms: Divided into quadrants - 20 scrubs per section.
• Initial Steps: General hand wash including forearms.
• Nails: Use nail pick during the first surgery scrub of the day.

Scrubbing Order

• Start with the fingers and hands on both sides.
• Proceed to forearms in alternating fashion.
• Keep elbows separate to maintain clean-to-dirty flow.

Gowning and Gloving

Preparation

• Gown: Should be pre-opened; inside facing you.
• Gloves: Should be opened and positioned correctly.

Sterile Drying

• Use a sterile towel, patting from fingertips to elbows.
• Ensure the towel doesn't touch anything non-sterile.

Putting on Gown & Gloves

• Gown: Drop into it, inside facing you; assistant helps secure.
• Closed Gloving Technique:
  • Keep fingers inside gown cuffs.
  • Palm up, lay glove palm-to-palm, fingers toward elbow.
  • Pull glove over hands without exposing fingers.
  • Ensure gown cuff is within palms.

Maintaining Sterility

• Avoid touching the front of gown or anything below the waist.
• Change gloves if contaminated:
  • Over-gloving: Use a larger size for the second layer.
  • Re-gloving: Have an assistant remove and replace gloves steriley.

Final Guidelines

• Practice closed gloving, especially for new practitioners.
• Always maintain sterile techniques in the surgical environment.

Questions & Practice

• Students encouraged to practice and ask questions for clarity.

These notes summarize key techniques and procedures for scrubbing, gowning, and gloving in a surgical setting, as discussed by Dr. Harold during the seminar.