Surgical Scrub
Surgical scrub is the removal of as many bacteria as possible from the hands and arms by mechanical
washing and chemical disinfection before taking part in a surgical procedure.
Purpose
Surgical Scrub helps prevent the possibility of contamination and infection of the operative wound by
bacteria on the hands and arms.
Types
Complete Scrub – it usually takes 10-15 minutes. This time may vary in different hospitals, depending upon
the frequency of the scrubs. This is done:
1. Before the first gowning and gloving.
2. Following a clean case if the gloves have holes in them.
3. Following a clean case if the gloves have been removed inadvertently before the gown.
4. Following a clean case if hands been contaminated in ay other way.
5. Following a contaminated case, before starting the next case.
Short Scrub – it is usually takes 5-10 minutes. This scrub is done following a clean case if the hands and arms
have not been contaminated. It is done to remove bacteria that have emerged from the pores and multiplied
while the gloves were worn.
PREPARATION BEFORE DOING SURGICAL SCRUB:
Attend to your personal needs.
Adjusts your cap and mask properly. The hair should be confined inside the cap. The mask should
cover the nose, mouth, cheek and chin.
Roll up sleeves of the uniform 3 inches above the elbow if sleeves are long
Check on the liquid soap and brush dispenser.
Remove your jewelry.
Check on your fingernails. They must be kept clean and short to reduce the bacteria count and to
prevent the puncturing or tearing of gloves.
SCRUB-UP TECHNIQUE
Take note of the time you started scrubbing
Wash hands and arms with soap and water to remove superficial dirt and bacteria.
Get the sterile brush with the right hand in such a way that it faces up.
Saturate the brush with soap and water and start scrubbing from the fingertip, to the four corners of
each finger, to the dorsum, palm and wrist. Do this for 2 1/2 minutes, rinse.
Transfer the brush to your left hand. Saturate it again with soap and water and do the same as in no 3
(5 minute for both hands).
Transfer the brush to your right hand. Saturate it again with soap and water and brush the left arm from
the wrist up to 2 inches above the elbow. Rinse, Do this for 2 ½ minutes.
Transfer the brush to your left hand and do the same as in no. 6 (5 minutes for both arms) hence a total
of ten (10) minutes, from the tip of the fingers up to 2 inches above the elbow.
Drop the brush in a pail provided for used brushes. Rinse both hands and arms well taking care the
flow of water is from the hands down the elbows.
POINTS TO REMEMBER IN SURGICAL SCRUB:
Rinse as often as possible using one direction only. Start from the hand going to the arm taking care
not to touch the faucet and the sink.
A person with cut or burn should not scrub because of the high bacterial count.
The hands and arms can never be rendered sterile no matter how long or how strong the antiseptics.
Surgical scrub is most effective when firm motion is applied. Short horizontal or circular stroke could be
used.
Use an ample supply of antiseptics
Since the hands are to be cleaner than any other area, after the initial hand wash, they are held higher
than the elbows during the rest of the procedure to prevent water from running back the scrubbed
hands.
Gowning
The sterile gown is put on immediately following the surgical scrub.
Purpose
The sterile gown is worn in order to permit the wearer to come within the sterile field and carry out
sterile technique during an operative procedure.
Parts of a Gown
1. Right Side 6. Neckband
2. Wrong Side 7. Belt
3. Body 8. Hemline
4. Sleeves 9. Back ties
5. Cuffs
Closed Method
This is the method with the least possibility of contamination.
PROCEDURE
With your right hands inside the gown’s sleeves, lift the glove by the cuff.
Put thumb down or your upturned left palm, fingers of glove pointed toward your elbow.
At this time, move your left hand so that your fingers are halfway down the cuff of your gown. Do not let
them protrude from our gown cuff or touch the end of the cuff.
With your right hand still inside the sleeve, take hold of the folded cuff of the left glove and pull it out
and over the left hand and well over the cuff of the left sleeve.
Take the right hand, still inside the sleeve, and grasp the left glove and gown cuff at the wrist and pull
glove unto the hand.
Proceed to the right hand the same way.
POINTS TO REMEMBER IN GLOVING:
Take care not to contaminate the outside surface of the glove
In serving the gloves, the nurse must have a wide base of support by putting her foot apart.
Always serve the right hand glove first.
In serving, get the right glove with the left and the left hand glove with the right hand.
Always keep gloved hands at waist level or above.
Keep gloved hands away from your mask.
REMOVING THE GOWN AND THE GLOVES
Regardless of whether the scrub nurse assists in a case or contaminated case remove first the gown
and then the gloves. Wash the gloved hands if they are grossly contaminated before removing the
gown.
Removing the Gown:
With the gloves still in, ask the circulating nurse to loosen the ties and the belt.
Grasp the right shoulder of the gown and slip off the arm allowing use sleeves to turn inside out.
Repeat the same procedure for the opposite shoulder.
Discard the gown in the hamper.
Removing the Gloves:
With the gloved right hand, remove the left glove by holding it at its outer surface and pull off.
(This is the glove to glove technique).
To remove the right glove, insert your thumb or three fingers between the skin and the glove and
pull off. (This is the skin to skin technique).