Scrubbing your hands is much more than the routine hand washing we all do before examining patients. It is a ritualistic procedure designed to increase safety for the patient and for you.
Before starting your scrub, make sure you are wearing a clean scrubsuit, surgical cap and surgical mask. The cap should completely cover your hair. The mask should fit securely, particularly over your nose, but not so tight that it impairs your breathing. If you should cough or sneeze, the exhaled air should be able to vent out the side of your mask. You will also need eye protection against splash of body fluids. Some surgical masks include a plastic screen. You may prefer to wear surgical goggles. Eyeglass wearers sometimes rely on their eyeglasses to protect them. The degree of protection depends on the size and fit of the corrective lenses.
Your hands have a lot of bacteria on them, particularly under the nails, within the skin oils, and at the bottom of the skin folds. In theory, it shouldn't matter how many bacteria are there since you will be wearing sterile gloves during surgery. In real life, those gloves often develop holes in them over the course of surgery.
The goal is not to eradicate every last bacterium from your skin (not possible), but to drastically reduce the number of bacteria on your skin both at the beginning of surgery and for its' duration. There are several very satisfactory ways to do that:
Once you have scrubbed, step back from the scrub sink and keep your hands away from your body and at about chest level. Keep them raised like this while you enter the OR (backwards through the door, using your hip to open it. This stylized position offers the best protection against you inadvertently contaminating your hands, and provides visual cues to those around you that your hands are scrubbed and should not be touched. If you accidentally touch something, just announce that you are contaminated, leave the OR and re-scrub.
OB-GYN 101: Introductory
Obstetrics & Gynecology
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