Scrubbing, gowning and gloving technique
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This document outlines proper scrubbing, gowning, and gloving technique for surgical procedures. It discusses removing transient and resident microorganisms from the skin through mechanical washing using scrubbing agents like soap, povidone iodine, or chlorhexidine for 5-10 minutes. Proper attire is also covered, including scrub suits, caps, masks, and protective clothing. The scrubbing procedure is described in steps from washing hands and nails to drying with towels. Gowning involves putting arms in a sterile gown without touching the outside and keeping hands in sight at all times. Gloves are put on using either an open or closed method.
Scrubbing, gowning and gloving technique
- 1. Scrubbing, gowning and gloving technique MAMC Surgical Post Graduate Surgical Skill Course
- 2. Aims and Objectives Effectively reduce the number of micro-organisms on the skin by mechanical washing.
- 3. Microorganisms on skin Transient :-Introduced by soil, dirt, contamination Resident:- under finger nails, deeper layers of skin i.e. sweat gland, hair follicles & sweat glands Scrubbing removes -most of transient bacteria -resident bacteria from surface & just beneath skin
- 5. Preparation for scrubbing Personal Hygiene Shower Healthy skin on hands, fingers, nails & arms. No boil, abrasion or wound on hands Free from cold or URTI
- 6. Finger Nails Short Not over tips of fingers Short nails Easy to clean Will not puncture gloves Free from nail polish Chipped nail polish can harbor bacteria No artificial nails
- 7. Jewelry Remove all jewelry i.e. rings, watches, bracelets from hands & arms Keep them at a sage place or in pocket Dead skin & accumulate beneath them
- 8. Theatre Attire Scrub Suit Surgical Cap & face mask Eye Wear/Wiser Shoes Protective wearing Plastic apron Lead apron
- 9. Scrub Suit Street clothes not allowed Short sleeved cotton scrub suit. Sleeves 4 inches above elbow Shirt tucked in trouser -to avoid shirt tail flapping on sterile field Trouser legs not touching floor - to avoid transport of bacteria
- 10. Shoes Street shoes not allowed Close ended shoes Chappals or open ended shoes not allowed Shoe cover for single use only
- 11. Surgical Cap & Face mask Surgical cap cover hair completely Including pierced ear rings Face mask cover nose & mouth completely
- 12. Protective clothing Lead apron if radiation exposure Plastic apron in every case
- 13. AREAS OF THE OPERATIVE SUITE (TRAFFIC PATTERNS) UNRESTRICTED- STREET CLOTHES PERMITTED SEMI-RESTRICTED- MUST HAVE SCRUB ATTIRE & CAP RESTRICTED-MASKS REQUIRED
- 14. FOOD/ DRINK NO food or drinks in Patient Care Areas Food/ Drinks must be consumed in Staff Lounges
- 15. Scrubbing Agents Soap 5 minutes Povidone iodine solution 2minutes ( 8ml required) Chlor-hexidine Solution (Hibiclens) 2 minutes (8ml needed)
- 16. Desirable properties of scrubbing agent Non irritating to skin Leaves minimum bacteria on skin Prolonged antibacterial effect on skin Should leather in hot, cold , or hard water
- 17. Scrubbing Procedure Nail brush for nails Water Steady flow Comfortable temperature. Hands above the level of the elbows Clothing should remain dry Movements steady.
- 18. Scrub technique Scrubbing do not include rinsing time Set water temperature Wet hands & forearms Hold soap in hands till scrubbing complete Keep hands elevated above elbow through out
- 19. Scrubbing Procedure Turn off taps with elbows keep hands elevated. skin should be blotted dry Use 2 towels Towel should be folded Discard towel immediately
- 20. Gowning Procedure Pick up gown from opened pack gown is folded with the inside uppermost. Slide both arms into gown Not to touch outside the gown. All gowns must be in a good state
- 21. PARAMETERS OF A STERILE GOWN GOWNS ARE CONSIDERED STERILE FROM WAIST LEVEL TO CHEST LEVEL INCLUDING SLEEVES TO 2’ ABOVE ELBOW STOCKINETTE CUFFS MUST BE COVERED BY STERILE GLOVES STERILE PERSONS MUST HAVE HANDS IN SIGHT AT ALL TIMES
- 22. Gloving Procedure The Open Method Closed Method
- 23. Once gowned and gloved stand with hand palms together Above the waist Away from the gown
- 24. At the end of the sterile procedure First remove the gown over the gloved hands Then the gloves. Hands should then be washed and dried. Gloves disposed of according to policy