1. Better Surgical Scrubbing For Safe Surgical Care
3M Health Care

 

  • share

    Better Surgical Scrubbing For Safe Surgical Care

    May 15, 2017
    share
    3M Background Pattern 3M Background Pattern 3M Background Pattern

    Scrub Those Pathogens Off: Safer Surgical Care

    Hand Hygiene takes on added significance where surgery is concerned. The importance of surgical scrubbing to avoid surgery site infections is a serious consideration.

    Scrub Those Pathogens Off: Safer Surgical Care

    Hand Hygiene takes on added significance where surgery is concerned. The importance of surgical scrubbing to avoid surgery site infections is a serious consideration.

    Scrub Those Pathogens Off: Safer Surgical Care

    Hand Hygiene takes on added significance where surgery is concerned. The importance of surgical scrubbing to avoid surgery site infections is a serious consideration.

    • Better Surgical Scrubbing For Safe Surgical Care

      Scrub Those Pathogens Off: Safer Surgical Care

      The power of the opposable human thumb is most evident in the performance of the most intricate and skilled tasks by human hands. What better evidence of this than the delicate and complicated surgeries that are performed by the adroit hands of surgeons?

      Unfortunately, the hands that heal can also cause harm if hand hygiene is not maintained. Improperly cleaned hands are a cause of pathogen transfer. Surgeries require the most sterile conditions. Donning sterile gowns and gloves is a prerequisite, of course. But it is also mandatory that all members of the sterile surgical team follow a stringent protocol for a surgical scrubbing.

      Skin: the first line of defence

      Unbroken skin is the first layer of defence against the invasion of microbes. Skin that is damaged by lesions, abrasions, cuts, and burns allows the influx of harmful pathogens. In addition, exudate (the ooze) from these sites of trauma may also result in the spread of microbes. These pose a risk for the patient as well as the member of the surgical team whether the transfer is from patient to surgical team member or vice versa.

      Pre-scrub

      The surgical scrub team has to have a ‘grooming’ schedule which involves:

      Short fingernails that do not extend above the fingertips: no artificial nails, no nail polish.

      The area between the fingernail and the finger, the quick, should be dirt and residue free.

      Why a surgical scrub?

      The sterile surgical team needs aseptic hands to reduce the risk of surgical site infection. A surgical scrub is necessary to remove transitory skin flora from the fingernails, fingers, hands, and arms of the surgical team. It reduces the resident microbial organisms to insignificant proportions. An efficient scrub formulation also inhibits the growth of bacteria.

      Scrubbing in the day of surgical gloves?

      Surgery, in pre-latex times, made scrubbing necessary for the reduction of surgical site infections. But why is scrubbing imperative in these days of surgical gloves?

      It is the opinion of experts that sterile gloves during surgery do not negate the necessity and the importance of scrubbing. Surgical gloves contribute to limiting the risk of surgical site contamination and reduce the risk of blood-borne pathogen transference from patients to the surgical team.

      But gloves can and do get punctured. Studies have shown that punctured gloves double the risk of site infections during surgery. There have been instances of outbreaks that can be traced to contaminated hands of surgical team members despite wearing sterile gloves.

      Scrubbing by the surgical team is necessary both for its own as well as patient safety.

      Scrubbing procedures

      As scrubbing and antiseptic formulation grew more effective and sophisticated, scrubbing time steadily decreased. There are as many scrubbing protocols as there are countries and medical beliefs.

      The recommendations of the Association of Professionals in Infection Control (APIC) underline the fact that the ideal duration of a surgical scrub has not been established: no research indicates whether longer or shorter scrubs are more effective. In part, this is related to the type of scrub solution that is being used. Each facility will have to draw on its experience and means to design a suitable surgical scrubbing procedure for itself.

      The numbered stroke method recommends a certain number of brushstrokes for each part of the hand from the tip of the finger to the back of the hand and arm.

      There is also the alternative timed-scrub procedure where each scrub should last the recommended length of time depending on the facility’s protocol and the scrubbing agent being used.

      Scrubbing agents

      At present, a 5-minute protocol for scrubbing with a disinfectant soap that contains either chlorhexidine or povidone-iodine and a brush is common.

      Alcohol-based hand rubs are now the dominant players on the surgical scrubbing stage. They are the most efficient antimicrobials in today’s scenario especially with regard to preoperative surgical hand preparation. Studies have shown them to be superior formulations which reduce bacterial counts immediately on scrubbing. Alcohol-based scrubbing formulations also inhibit the regrowth of bacteria on the gloved hand. Hands must be completely dry before applying hand rub formulations for maximum efficacy.

      Hand hygiene is a major concern in health care in general, but it is of paramount significance in the sterile environment of the OR where patients undergo surgical procedures and are at significant risk for perioperative nosocomial infection. Even the best OR design and the best surgical skills and technique will not compensate for the failure to pay attention to infection prevention.

      Effective scrubbing procedures for the whole surgical team suitable to the scrubbing agent being used are of supreme import.

      Author: Shraddha Sawant, RGNM , PGDHA

      Senior Manager - OT & Cathlab, Global Hospitals Mumbai

      Contact us for more information on 3M Hand Hygiene products .

      All fields are required unless indicated optional

      • The information you provide on this Contact Us form will be used to respond to your request and as further described in our Internet Privacy Policy.

        Please be aware that this information (including the original and the subsequent reply) may be transferred to a server for metrics and storage. If you do not consent to this use of your personal information, please do not use the Contact Us system.

      • Send
      • view 3M Hand Hygiene products
      Thank you for contacting 3M.

      Our goal is to respond to your request within 24-48 hours. Some questions, however, may need further investigation to provide you with an appropriate response.