to the skin, they are difficult to remove. However,
their growth is inhibited by the antiseptic action
of the scrub detergent used. Transient bacteria are
usually acquired by direct contact and are loosely
attached to the skin. These are easily removed by
the friction created by the scrubbing procedure.
Proper hand scrubbing and the wearing of
sterile gloves and a sterile gown provide the pa-
tient with the best possible barrier against
pathogenic bacteria in the environment and
against bacteria from the surgical team. The
following is the generally accepted method for the
surgical hand scrub:
Before beginning the hand scrub, don a
surgical cap or hood that covers all hair,
both head and facial, and a disposable
mask covering your nose and mouth.
Using approximately 6 ml of antiseptic
detergent and running water, lather your
hands and arms to 2 inches above the
elbow. Leave detergent on your arms and
do not rinse.
Under running water, clean your finger-
nails and cuticles, using a nail cleaner.
Starting with your fingertips, rinse each
hand and arm by passing them through the
running water. Always keep your hands
above the level of your elbows.
From a sterile container, take a sterile
brush and dispense approximately 6 ml of
antiseptic detergent onto the brush and
begin scrubbing your hands and arms.
Begin with the fingertips. Bring your
thumb and fingertips together and us-
ing the brush, scrub across the finger-
tips using 30 strokes.
Now scrub all surface planes (4) of the
thumb and all surfaces of each finger,
including the webbed space between the
fingers, using 20 strokes for each sur-
Scrub the palm and back of the hand
in a circular motion, using 20 strokes
Visually divide your forearm into two
parts, lower and upper; scrub all sur-
faces of each division 20 strokes each,
beginning at the wrist and progressing
to the elbow.
Scrub the elbow in a circular motion
using 20 strokes.
Scrub in a circular motion all surfaces
to approximately 2 inches above the
Do not rinse this arm when you have
finished scrubbing. Rinse only the
Pass the rinsed brush to the scrubbed
hand and begin scrubbing your other
hand and arm, using the same pro-
cedure outlined above.
Drop the brush into the sink when you
Rinse both hands and arms, keeping
your hands above the level of your
elbows, and allow water to drain off
When rinsing, do not touch anything
with your scrubbed hands and arms.
The total scrub procedure must include all
anatomical surfaces from the fingertips to
approximately 2 inches above the elbows.
Dry your hands with a sterile towel. Do
not allow the towel to touch anything other
than your scrubbed
hands and arms.
follow the same hand
Gowning and Gloving
If you are the scrub corpsman, you will have
opened your sterile gown and glove packages in
the operating room before beginning your hand
scrub. Having completed the hand scrub, back
through the door holding your hands up to avoid