Scrubbing in surgery refers to the process of decontaminating the hands and forearms before a surgical procedure. This is followed by donning a sterile surgical gown and gloves. This practice is critical for maintaining a sterile environment and significantly improving patient outcomes.
Why is Scrubbing In Important?
The primary purpose of scrubbing in is to reduce the risk of infection during surgery. By eliminating as many microorganisms as possible from the hands and forearms of the surgical team, the likelihood of introducing pathogens into the surgical site is dramatically reduced. The reference confirms that "scrubbing in 'dramatically reduces the risk of infection and significantly improves patient outcomes'."
The Scrubbing In Procedure: A Detailed Look
While specific protocols may vary slightly, the general procedure for scrubbing in involves the following steps:
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Preparation:
- Remove all jewelry (rings, watches, bracelets).
- Ensure fingernails are short, clean, and free of artificial nails or polish.
- Wear appropriate surgical attire, including a surgical cap and mask.
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Hand Washing:
- Wet hands and forearms with water.
- Apply an antiseptic soap or scrub solution (e.g., chlorhexidine gluconate or povidone-iodine).
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Scrubbing:
- Using a sterile scrub brush or sponge, scrub all surfaces of the hands and forearms, including between the fingers and under the fingernails.
- A timed scrub (typically 3-5 minutes) or a counted stroke method may be used.
- Maintain the hands higher than the elbows throughout the scrubbing process to prevent contamination.
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Rinsing:
- Rinse hands and forearms thoroughly with water, allowing the water to run from the fingertips to the elbows.
- Avoid splashing water onto scrubbed areas.
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Drying:
- Enter the operating room and use a sterile towel to dry hands and forearms, starting with the fingertips and working towards the elbows.
- Use a blotting motion rather than rubbing.
- Dispose of the towel properly.
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Gowning and Gloving:
- Don a sterile surgical gown, ensuring that the back of the gown is fastened by another member of the surgical team.
- Put on sterile surgical gloves, using either a closed-glove or open-glove technique, depending on the situation.
Maintaining Sterility
Once scrubbed, gowned, and gloved, it is crucial to maintain sterility. This involves:
- Avoiding contact with non-sterile surfaces.
- Keeping hands within the sterile field (typically above the waist and below the shoulders).
- Turning one's back to the sterile field if needing to move or adjust.
- Alerting other team members if a breach in sterility occurs.
