from polish, and the cuticles are trimmed. Then,
surgical product, a nail cleaner, and a sterile hand
brush or sponge. These materials are available in the
scrub area. Before scrubbing, remove all rings,
watches, or other jewelry from your hands and arms.
Ensure that your fingernails are short, smooth, free
complete the following procedures:
Wet your hands and arms with water. Put a small
amount of antimicrobial surgical product in the
palm of your hand and spread the solution over
your hands and arms. Work the solution into a
Clean your nails and cuticles with a nail cleaner
under running water. When you are through,
discard the nail cleaner.
Rinse your hands and arms under running water.
Wet the brush or sponge and place a small
amount of the antimicrobial solution on the
bristles. Scrub each hand and arm in the
Place your fingers together and scrub across
the tips for 30 strokes.
Starting with your thumb, scrub each finger
on all surfaces. Use 20 strokes for each finger,
and make sure that the webbed areas between
the fingers are scrubbed.
After you have scrubbed each finger, scrub
your palm. Use a circular motion and scrub for
Scrub from your wrist to 2 inches above your
elbow. Brush in one direction only (away
from the wrist) and scrub for 20 strokes.
WITHOUT RINSING, wash your other
hand and arm in the same manner. Then
discard the hand brush or sponge.
5. Rinse both hands and arms. Hold your hands
higher than your elbows and allow the water to
flow from your fingertips to your elbows.
NEVER move your hands back and forth
through the water. Allow the water to drip from
your elbows for a few seconds before leaving
the scrub area. When leaving the scrub area,
hold your hands close together and away from
your body. DO NOT touch anything.
6. While the scrub assistant and the dentist scrub,
the circulating assistant will open the surgical
drape pack, being careful to touch only the
outside edges of the pack. When the scrub
assistant enters the operating room, use a sterile
towel from the pack to dry the hands and arms,
being careful not to drip on the sterile field.
7. On one half of the towel, use a blotting action to
dry one hand and arm, from the fingers to above
the elbow. Dry your other hand and arm in the
same manner with the other half of the towel.
NOTE: When drying, bend at the wrist and hold
your hands and arms away from your body. This
will keep the sterile towel from coming in
contact with your unsterile scrub suit.
8. When this procedure is complete, pass the towel
to the circulating assistant.
NOTE: The above scrubbing routine is normally
performed for the first case in the morning and again
after lunch. Otherwise, an abbreviated scrub
procedure, consisting of a 2-minute washing pro-
cedure of your hands and arms with antimicrobial
surgical product should be performed.
After the scrubbing procedure is completed, the
surgical team will don sterile surgical gloves. Gloving
procedures are the same for the dentist and the scrub
The circulating assistant will open the packages of
disposable sterile gloves, touching only the outside
edges of the packages. The procedures for putting on
the gloves are as follows:
Without touching the gloves, fold back the
tissue paper covering. The cuff of each glove is
folded so that the inside of the cuff is partially
exposed. NOTE: Touch only the inside portion
of the glove with your bare hand.
Grasp the first glove at the cuff fold (fig. 5-51).
Gently pull the glove onto your free hand and
anchor the cuff over your thumb (fig. 5-52).
Slip the fingers of your gloved hand under the
folded cuff of the second glove. Keeping your
fingers under the folded cuff, begin to work the
second glove onto your bare hand (fig. 5-53). Do
this gently so that the cuff remains folded. Work
the glove up, and over your hand and wrist, and
onto your arm (fig. 5-54). As you do this,
gradually unfold the cuff so that its inner side is
now against your skin. Remember that you
cannot touch this exposed inner side with your
gloved hand. Finally, grasp the outside of the