The LSUHSC New Orleans Emergency Medicine Interest Group Presents The Student Procedure Manual

Surgical Scrubs

Purposes and Principles

• These recommended practices serve as an outline for accomplishing the surgical scrub. The surgical scrub is a necessary part of aseptic practice within the operating room suite. Although sterile gloves are worn by the surgical scrub team, the skin of their hands and forearms should be routinely degermed to reduce the microbial flora in the event of glove failure.
  
• The objectives of the surgical scrub are:
  
  • To remove soil and transient microbes from the hands and forearms.
    
  • To reduce the resident microbial count to as low a level as possible.
    
  • To inhibit rapid rebound growth of microbes.
    
• All personnel should meet specified requirements prior to beginning the surgical scrub.
  
  • All jewelry should be removed from the hands and forearms.
    
  • Fingernails should be free of polish and trimmed short. Cuticles should be in good condition.
    
  • Hands and forearms should be free of open lesions and breaks in skin integrity.
    
  • All personnel should be appropriately attired.
    
• The antimicrobial soap or detergent should be effective.
  
• An anatomical timed scrub or a counted brush stroke method should be used for all surgical scrubs. The CDC recommended time is 5 minutes for a surgical scrub.
  
  • The anatomical timed scrub method allots a prescribed amount of time for each anatomical area.
    
  • The counted brush stroke method allots a set number of brush scrub strokes to each designated surface of the hands and forearms.
    
    1. Open one sterile scrub brush.
       
    2. Clean nails with "nail pic" under running water and scrub hands and forearms to remove gross contamination; rinse hands and forearms.
       
    3. Begin scrubbing the outside of little finger-left hand, and continue scrubbing, progressing to the outside of thumb; ten (10) strokes per each surface area.
       
    4. Scrub palm of hand using circular motion.
       
    5. Close hand, scrub nails, then knuckles progressing to back of hand.
       
    6. Repeat steps three (3) through (5) for right hand and forearm.
       
    7. Discard brush and rinse hands and forearms keeping hands higher than elbows. Be careful not to touch sink and/or fixtures.
       
    8. Hold hands up and below eye level; elbows down and away from scrub clothes.
       
    9. Total scrub should be five (5) minutes.