Before each operation, all members of the surgical team – that
is, those who will touch the sterile surgical field, surgical
instruments or the wound – should scrub their hands
and arms to the elbows. Scrubbing cannot completely sterilize
the skin, but will decrease the bacterial load and risk of
wound contamination from the hands.
Every hospital should develop a written procedure for scrubbing
that specifies the length and type of scrub to be undertaken.
It is usual that the first scrub of the day is longer (minimum
5 minutes) than any subsequent scrubs between consecutive clean
operations (minimum 3 minutes).
When scrubbing (Figure 2.4):
all jewellery and trim the nails
soap, a brush (on the nails and finger tips) and running
water to clean thoroughly around and underneath the nails
your hands and arms up to the elbows
scrubbing, hold up your arms to allow water to drip off
off the tap with your elbow
scrubbing your hands:
them with a sterile towel and make sure the towel does
not become contaminated
your hands and forearms away from your body and higher
than your elbows until you put on a sterile gown and
sterile gloves (Figures 2.5 and 2.6).
gloves prevent transmission of HIV through contact with blood,
but there is always the possibility of accidental injury
and of a glove being punctured. Promptly change a glove punctured
during an operation and rinse your hand with antiseptic or
re-scrub if the glove has leaked during the puncture. Patient
safety is of primary concern; do not compromise it. Change
your gloves only when it is safe for the patient.