This presentation highlights basic principles of operation room attires.

1. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc)
OPERATION ROOM ATTIRE

2. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
OR Attire/PPE
Purpose:– To provide effective barriers that prevent the dissemination of
MOs to the pt and/or from the pt.
General Principles:
►Each operating room department should have a specific complete
written policy.
►Only approved clean OR attire worn with in restricted area of OR suites.
►The OR attire is not worn outside of OR suite.
►Eye glasses should be wiped with tissue wet with antiseptic solution.
►Comfort table supportive shoes should be worn to relieve fatigue.
►Personal hygiene must be re-emphasized.
►No, person with acute infection allowed to visit OR.

3. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Components of OR Attire and PPE
 Body cover
 Mask
► muslin – 40%
► Muffin – 99%
 Head cover/caps
 Foot cover/shoes
 Goggles
 Gloves
 Mackintosh/plastic apron
 PPE should include
► Hair cover
► Eye protection
► Fluid-resistant facemask
► Fluid-resistant gown
► Gloves
► Shoe covers or Boots

4. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Gloves
Types of Gloves
►Sterile/HLD surgical glove
►Clean examination glove
►Utility/heavy duty gloves
►Elbow length gloves
When to Double Gloves
►The procedure that involves contact with large amounts of blood/body
fluids.
►Orthopedic procedure in sharp bone fragments, wire sutures and other
sharps.
►Surgical gloves when re-used.
►Surgical procedures lasting more than 45 minutes.
By Ame M.

5. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Gloves
Elbow Length Gloves
►Are Used During:-
 Vaginal deliveries.
 Cesarean section.
 Manual removal of placenta.
 Large volume of blood/body fluids contact.
 Cut the four fingers of gloves completely off.
 sterilize or disinfect 2-3 pairs of cut off (finger less) gloves.
By Ame M.

6. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Gloves
Some Do’s and Don’ts about gloves
►Do – wear the correct size gloves
►Do – change s- gloves every 45 minutes ’
►Do – keep finger nails trimmed moderately short.
►Do – pull the gloves up over cuffs of gown
►Do – use water soluble hand lotions
►Don’t – oil based hand lotions or creams.
►Don’t – use latex gloves if you have allergy.
►Don’t – store gloves that are cracked.
►Don’t -reprocess gloves that are cracked.
►Don’t –reprocess exam gloves for reuse.

7. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Surgical Scrubbing
Definition:-
►It is the process of removing as many MOs as possible from the
hands and arms by mechanical washing and chemical antisepsis
before participating in an operative procedure.
 Purpose
►To remove soil, debris natural skin oil, MOs from the hands and fore
arms of the surgical team/sterile team.
►To decrease the no of MOs on skin to an irreducible minimum.
►To reduce the hazards of microbial contamination of the operative
wound by skin flora.
►To keep the population of the MOs minimal during the operative
procedure by suppression of growth.

8. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Surgical Scrubbing
Before a surgical operation
►Alcohol hand rub
►Routine hand wash 10-15 seconds
►Aseptic procedures 1 minute
►Surgical wash 3-5 minutes

9. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Surgical Scrubbing…………cont’d
General preparations
►The skin and nails should be kept clean.
►Finger nails should not reach beyond the finger tip.
►Finger nail polishing avoided.
►Artificial devices should not cover natural finger nails.
By Ame M.

10. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc)
Before You Wash
Bad
Good
Jewelry and Watch
 It is hard to clean under your jewelry or watch
 Bacteria and dirt can sit under your jewelry or watch
 Remove jewelry to ensure a complete clean

11. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc)
Nail Polish and False Nails
Bad
Good
If it is less than 4 days old
you can keep it on
Nail Length
Bad
Good

12. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc)
Result
Skin Integrity (condition)
No jewelry
No watch
No nail polish
No false nails
No long nails
No cracked skin
You are now ready to
wash
Bad
Cuts, breaks and weeping
can spread infection
Good
No open wounds,
bleeding or weeping

13. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc)
Procedures
►The pre-operative surgical antisepsis
consists of three processes.
 Hand hygiene
 Gloving of the surgical team
 Applying antiseptic agent to the surgical
site
Methods
►Two methods:
 The counted brush-stroke method
 The time scrub method
 Note: The Surgical Scrub is Prior to
Gowning.
 The length of surgical scrubbing
depends on:
►The frequency of scrubbing.
►The agent used.
►The method used.
Surgical Scrubbing…………cont’d

14. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Procedures of Surgical Scrubbing
Do not scrub if you have an infection.
Make sure all hair is covered and that you are
protected from splashes.
Remove jewelery (rings, watches, and bracelets)
Wash hands thoroughly around nails, b/n fingers
and forearms to the elbow with soap,
brush/sponges, running water.
Clean nails with nail cleaner.
Scrub hands, arms up to elbows.
By Ame M.

15. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
Procedures of Surgical Scrubbing
 Rinse hands and fore arms with water.
 After scrubbing, hold up arms to allow water to drip off elbows.
 Apply antiseptic agent to all surface of hands and forearm.
 Rinse hands and fore arms with clean water.
 Turn off tap with elbow.
 Hold hands, forearms away from body and higher than elbows and
don’t touch any surface until putting on sterile gown and gloves.
 Dry hands from distal to proximal with sterile towel, make sure towel
does not become contaminated.
 Put sterile surgical gown, then gloves on both hands after drying
hands.

16. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
Gowning & gloving
 The sterile gown is put on immediately after the surgical scrub.
 General consideration
►The scrub person gowns and gloves himself.
►Gown packages opened on separate table.
►Avoid splashing water on scrub attire.
 Place arms through sleeves.
 Have a non-scrubbed assistant pull gown over shoulders so
hands go through sleeves
 Assistant will tie back of gown
 The circulator assists gowning.

17. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Gowning
By Ame M.

18. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
Surgical Gloving
don immediately after gowning.
Easiest to have someone who is already gowned
and gloved to assist.
Techniques - two types
►Closed Vs Open

19. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
GLOVING without Assistance
 Open sealed package of sterile gloves before scrubbing,
gowning; place inner package on sterile surface.
 Once gowned, take cuff of left glove with rt hand (1);
►make sure thumb in correct position
 Slide glove onto left hand, wriggle fingers slightly to help
 Only touch inside of glove, cuff with bare hands
 Slide fingers of gloved left hand into cuff of rt glove (2)
 Pull glove onto rt hand in similar fashion to placing left glove
(3)
 Ensure that cuffs cover ends of both gown sleeves (4)

20. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
Precautions when Gloving/Degloving
Do not allow your skin to touch the outer surface of
the glove.
Keep your fingers inside the sleeve of the gown
until the glove is on.
If contamination occurs, both gown and gloves
must be replaced.
Gloves are removed after the gown using a glove-
to-glove, then skin-to-skin technique.

21. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
SKIN PREPARATION
►Before operation, wash surgical site, surrounding area with
soap, water; particularly wash debris from injuries.
►Prepare skin with antiseptic solution; start in centre, move to
periphery.
►This area should be large enough to include entire incision,
adjacent working area.
►Solution should remain wet on skin for at least two minutes.
►Chlorhexidine gluconate and iodine preferable to alcohol
as less irritating to skin.
Skin Preparation and Draping of Surgical Site

22. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Skin Preparation
Procedure
1. Expose only the skin area to be prepared.
2. Wear sterile gloves.
3. Place towels above and below to protect gloved hand from
touching the blanket.
4. Wet the sponge with antiseptic agent but squeezed out.
5. Scrub the skin.
6. Discard the sponge after reaching the periphery.

23. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
DRAPING
 is" the procedure of covering pt and surrounding areas with a sterile barriers to create and
maintain sterile field during operation.“
 done after scrubbing, gowning, gloving
 only operative field (prepped area) and areas necessary for anesthesia left uncovered.
 Drapes secured with towel clips at each corner.
 Proper draping exposes only the surgical site, which decreases the risk for infection.
 Types of Drapes:
1. Towels
2. Laparotomy sheet
3. Stockinet
4. Ortho pack sheet

24. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
DRAPING

25. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing

26. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Summary

27. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Summary……

28. July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
Introduction to OR Technique
By:- Ame Mehadi (BSc, MSc-EMCCN)
July, 2021 © Haramaya University, CHMS,
Department of Emergency and Critical Care Nursing
References
 Berry & Kohn: Introduction to Operating Room Techniques, 3rd Edition (The Blakiston Division,
McGraw-Hill Book Company, 1966)
 Abebaw Eredie: Operating Room Technique LECTURE NOTES For Nursing Students, Ethiopia
Public Health Training Initiative, USAID, 2008.
 A Guide to Operating Room Technique by Irene Gregory, June 1969.
 Introduction to the Operating Room U.S. Army Medical Department Center and School Fort Sam
Houston, Texas 78234-6100, 100th Edition.
 Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery
 Internet sources