This document provides instructions for surgical scrubbing, gowning, and gloving before entering an operating room. It describes a two-phase process for scrubbing hands and forearms with soap and water followed by rubbing with a disinfectant for 5 minutes. It details how to properly put on and tie a surgical gown with assistance and how to don sterile gloves, starting with the left hand first, while being assisted by a scrub nurse. The goal is to reduce bacteria on the skin and provide a sterile surgical field.

1. Surgical Scrubbing,
Gowning & Gloving
Mr. Harshad Khade
MSc. Medical Technology (OTA)
Symbiosis International University, Pune.

2. Changing the clothes
Entry into the operating theater is allowed only in operating room
attire and shoes worn exclusively in the operating room.
Surgical cap, face mask
The surgical team members should wear surgical caps and face masks
before entry into the operating room. The cap should cover the hair
completely. The mask should be tied securely.
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3. Scrubbing, surgical hand disinfection
• Surgical hand scrub should be done before any operation and sterile
intervention.
• Hands can not be made sterile.
• The aim of the scrub is to reduce the number of transient and
resident bacteria.
• The scrub eliminates the transient flora of the skin and blocks the
activity of most resident germs located in the deeper layers.
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4. First Phase
• Mechanical cleaning is the First Phase of scrubbing.
• Wash the hands and forearms (up to elbow) thoroughly with the soap
and warm tap water.
• The first phase should last till that time when we are satisfied of a
thorough and careful washing (it does not have a time limit).
• After this, use a tissue paper to make your hands and forearms dry.
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5. Second Phase
• The Second Phase is hand disinfecting.
• Rub with a disinfectant hand scrub agent for 5 × 1 minutes.
• The disinfected area should extend to the elbow.
• The unwashed skin should not be touched with the clean hands.
• This process should be repeated four times more, but the affected
area will be smaller and smaller.
• The second time, the dividing line is at 2/3 of the forearm; the third
time, it is on the middle of the forearm; and the fourth time only 1/3
of the forearm is involved.
• With the fifth dose we rub only the wrists and hands
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6. • The assistant -after scrubbing- enters the operarting room and does
the disinfectioning of the surgical territory.
• The surgeon enters the surgical suite immediately after the scrub.
• The hands are held above the elbows, in front of the chest to avoid
touch any non-sterile object.
• After scrubbing, there is a need for an Immediate Gowning
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7. The Gowning Procedure
• Lift the gown while you are grasping its middle part.
• Catch its neck piece. While keeping it away from your body, allow it to
unfold.
• Find the neck line and while holding the gown at this area unfolds it in
a way that it’s inner part is facing you.
• Turn the armholes towards yourself.
• While holding the neck parts of the gown throws it up in air just a
little and with a defined movement insert both arms into the
armholes.
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8. • The assistant/scrub nurse stands at the back and grasps the inner
surface of the gown at each shoulder.
• The gown is pulled over the shoulders and the sleeves up over the
wrist. Meanwhile the cuffs of the gown can be adjusted.
• If there is a band, use it to fix the cuff.
• The assistant ties the bands at the back of the gown.
• Then, with your right hand catch the strile right band located at the
waist region of the gown and while crossing your (right) arm give this
band to the assistant who grasps it without touching the gown and tie
it at the back.
• It is important to know that these parts of the gown which are
touched by the non-sterile assistant will loss their sterility and should
not be touched by you
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9. Gloving
• Gloving is assisted by a scrub nurse already wearing a sterile gown and
gloves.
Rules of gloving:
• The scrub nurse holds the glove towards you in a way that the plam of the
glove is facing you.
• In our institute it is customary to wear the left hand glove first.
• In this case, put two fingers of your right hand into the opening and pull
the inner side of the glove towards you.
• Slip your left hand into the glove.
• Then, with your gloved left hand catch the outer side of the right hand
glove - which is now kept in front of you- to open it.
• Thrust your right hand into the glove.
• After both your hands are gloved you may then adjust your gloves so that
they fit comfortably on the hands
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10. “
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