11/13/24, 7\:27 PM Guide | Scrubbing

Scrubbing

Table of contents

Introduction

The surgical scrub is an important procedure required to reduce the risk of contamination by microorganisms during operative
procedures.
The surgical scrub involves
This guide will take you through the important considerations when scrubbing for theatre, in particular\:
1. Preparing to scrub
2. Surgical hand wash
3. Gloving and gowning

Preparing to scrub

You should be dressed appropriately to enter the operating theatre. Although this may vary from hospital to hospital, generally
you must wear\:
Surgical scrubs (bare below the elbows, including removing watches and rings)
Footwear such as clogs
Theatre hat (with hair tied up if necessary)
ID badge
Ensure you ask the Lead Surgeon whether or not they would mind you scrubbing in, then make your way to the scrub area.
You must open your gown and gloves b e f o r e you scrub, so as not to contaminate your hands\:
First, open the gown. Carefully use the edges of the paper to open the packet and expose the surgical gown.
Next, choose your gloves. Peel the plastic glove packet open over the gown and drop the gloves onto the sterile gown
without touching them.
This will ensure your gloves and gown are untouched, and therefore sterile.
Finally, put on a surgical mask and eyewear protection. Make sure you are comfortable, as you cannot adjust these once
you are scrubbed.
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Operating theatre attire

Surgical scrub

Pre-scrub wash

1. Run the tap to an adequate temperature and
ensure the temperature is comfortable.
2. Open the package containing the nail brush/scrub sponge and nail pick, then lie it on the back of the scrub sink still in the
opened package.
3. Wet the hands and arms for an initial pre-scrub wash. Use several drops of scrub solution and work up a heavy lather, then
wash the hands and arms to the elbows.
Cleansing solutions are non-irritating to most people and include\:
Povidone Iodine
Chlorhexidine
Some hospitals use dispensable alcohol gel, which can be used between short,
surgeon if they are happy for you to use this.
4. Rinse the hands and arms thoroughly, allowing the water to run from the hands to the elbows.
‘clean’ procedures. Check with the operating
5. Remove the sterile nail brush and nail pick from the opened package. Clean under the nails with the nail pick and then
discard in the bin (making sure not to touch the bin by using a foot-pedal).
6. Moisten the nail brush and dispense antimicrobial solution onto the sponge-side.
7. Lather the
8. Then using the bristle side of the nail brush, scrub the spaces under the
process on the other hand.

Scrubbing procedure

During each of the following steps keep hands (clean area) above the elbows (dirty area) allowing water to drain away, making
sure to avoid splashing surgical attire.
Each step of surgical ‘scrubbing’ consists of
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Step 1
Wet the hands and forearms.
Apply the speci
dispenser (one downward stroke action).
Work the cleaning solution into the hands palm to palm, creating a lather.
Rinse hands and forearms
Step 2
Rub the right palm over the back of the left and vice versa with the
Rub the right palm over the back of the left and vice versa with the
Step 3
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Rub hands palm to palm, with
Rub hands palm to palm, with
Step 4
versa.
Perform rotational rubbing backwards and forwards with clasped
Perform rotational rubbing backwards and forwards with clasped
Step 5
Perform rotational rubbing of the right thumb clasped in the left hand and vice versa.
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Perform rotational rubbing of the right thumb clasped in the left hand and vice versa
Step 6
Rub the
Rub the
Step 7
Continue with the rotating action down opposing arms, working to just below the elbows.
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Continue with the rotating action down opposing arms, working to just below the elbows
Step 8
Rinse and repeat steps 1-7 keeping hands raised above elbows at all times.
The second wash should only cover two-thirds of the forearms to avoid compromising the cleanliness of the hands.
Local policy may include repeating these steps a third time but to wrists only.
The scrub procedure should last for 5 minutes, with further scrubs during the day lasting 3 minutes.
Step 9
Rinse the hands under running water, allowing the water to run from
Turn the tap o
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Rinse hands and forearms
Step 10
Pick up one hand towel from the top of the gown pack and step back from the surface.
Grasp the towel and open it fully. Do not allow the towel to touch any unsterile object or unsterile parts of your body.
Hold your hands and arms above your elbow, and keep your arms away from your body.
Step 11
Holding one end of the towel with one hand dry the
Move to the dry area of the towel and continue in this manner down the forearm to the elbow.
Ensure you do not retrace from the forearm back up to the hands and do not wipe the skin dry. This may contaminate your
hands with micro-organisms from your proximal forearm - you will be asked to re-scrub.
Repeat with the other towel from the pack for the other hand and arm.
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Dry each arm, starting at the
If you accidentally touch the tap or any surrounding objects, you must re-scrub.

Gowning

Picking up the gown

1. With one hand, pick up the entire folded gown from the wrapper by grasping the gown through all layers, being careful to
touch only the inside top layer which is exposed.
2. Once your hands are securely pinching the gown in these slots, step back from the shelf and allow the gown to drop.
3. Make sure the gown does not touch any surrounding unsterile objects.
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Pick up gown pack

Inserting your arms into the sleeves of the gown

4. Grasp the inside shoulder seams and open the gown with the armholes facing you.
5. Carefully insert your arms partway into the gown one at a time, keeping hands at shoulder level away from the body.
6. Slide the arms further into the gown sleeves and when the
inside seam at the cu
Put your hands into the sleeves

Fastening the gown

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7. A theatre assistant will fasten the gown behind you, positioning it over the shoulders by grasping the inside surface of the
gown at the shoulder seam. The theatre assistant's hands should only ever be in contact with the inside surface of the gown.
8. The theatre assistant then prepares to secure the gown at the neck and upper back. Gowns di
but most with have either ties, buttons or velcro tabs.
An assistant should fasten the gown behind you

Gloving

Step 1
Open the inner glove packet that you previously dropped onto your sterile
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Open the inner glove packet
Step 2
Pick up one glove by the folded cu
Pick up one glove by the folded cu
Step 3
Place the glove on the opposite gown sleeve facing palm down, with the glove
hand inside the gown sleeve must be facing upward toward the palm of the glove.
Place the glove's rolled cu
the glove with the thumb and index
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Place the glove on the opposite gown sleeve facing palm down, with the glove
Step 4
While holding the glove's cu
Grasp the uppermost edge of the glove’s cu
Step 5
Continuing to grasp the glove, stretch the cu
Using the opposite sleeve covered hand, grasp both the glove cu
any excessive amount of glove sleeve from underneath the cu
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