SURGICAL SCRUBBING - Commercially prepared
2. Disposable surgical scrub
• Process of removing microorganisms as many
as possible from the skin of the hands and
arms by mechanical and chemical antisepsis
• Important procedure to reduce the risk of
contamination by microorganisms during
surgical procedures
• Done every time there is a surgical procedure
and perform prior to surgical procedure
• NOT A STERILE PROCEDURE!!
• Slows the growth of the bacteria
TYPES OF MICROORGANISM PRESENT IN
SKIN
RESIDENT
• Natural habitat is the skin (pt and or team
members)
• Gram positive and gram negative bacteria
• Fingernails and in the deeper layers of the skin
(hair follicles, sweat glands, sebaceous glands)
o Abundant resident microbial flora
o Most pathogen can cause disease or
infection
• More adherent to skin, more resistant to
removal
TRANSIENT
• Contacts
• Not commonly found on the skin
• Ex.: candida and pneumococcal
microorganisms
• Easily removed by handwashing
PURPOSE OF SURGICAL SCRUB
• Prevent wound infection
• Remove soil, debris, natural skin oil, lotion sa
hands
• Reduces resident microorganism on the skin
TYPES OF BRUSH
MECHANICAL
• Remove with friction
CHEMICAL
• With antimicrobial agent
• With the use of surgical scrub brushes
1. Reusable scrub brush
- Common in ph setting particularly in the
gov setting
- Reusable brushes should be soaked in
antiseptic solution for specific period of
time before it can be used again
- Use in ideal setting
- Debris should be removed from the
sublingual area of each finger using a nail
picker
- Included sa package yung nail picker.
Single use lang
- Reusable nail cleaners, not recommended
- Orange woodstick, hindi din.
- Toothpick, hindi din kasi pwede ka magka
splinter
3. Brush sponger combination
- Impregnated with antiseptic solution yung
sponge
- Sponge is usually used as lathering
- Yung bristles, used for brushing
CHARACTERISTICS OF ANTISEPTIC
• Antimicrobial action
• Persistent activity
• Safety
• Acceptance
TYPES OF ANTISEPTICS
1. CHG (CHLORHEXIDINE GLUCONATE)
• Action: exerts and antimicrobial effect
against gram positive and gram
negative bacteria, fungal and viral
microorganisms
• Reacts poorly TB microorganisms
• If used repeatedly, it will produce
prolong effect and antimicrobial
residues that tends to accumulate on
the skin
• Residual effect: maintained for more
than 6 hours
2. IODOPHOR
• Povidone iodine complex
• Effective in surgical scrubbing
• Concentrations: 10%, 7.5%, 2%
and 0.5%
• has minimal residual effect,
irritating to the skin
• should not be used, allergy to
iodine
3. PCMX
(PARACHLOROMETAXYLENOL)
• Used in concentration: 1% and 3.75%
• Does not substantially reduce
microorganisms immediately
TYPES OF SINKS
1. Foot controlled
2. Knee controlled
 3. Elbow controlled

SCRUBBING
LENGTH OF SCRUBBING

• Varies from institution to another

• Based on manufacturer recommendation
TWO TYPES OF SURGICAL SCRUBBING
1. TIME METHOD
- Complete scrub 5-7 minutes
o Consider the protocol of the
agency
- Short scrub – 3 minutes
2. BRUSH STROKE METHOD
- Nails – 30
- Side of fingers – 20
- Back of the hand – 20
- Arms – 20
- We count the brush in the area
- Cleanest to dirtiest = fingers to elbows
SURGICAL GOWN SOLO DRESS
INDICATION OF SHORT SCRUB
• In the morning before the first gowning and
gloving
• Following a clean case if the gloves has been
removed before the gown
• Following a clean case if glove have had
punctured
• Following a clean case if hands have been
contaminated in any other way
• Before an emergency case at anytime
DRYING HAND AFTER SURGICAL SCRUB
TWO PERSON GOWNING
- Touch only the inside of the gown
1. Grasp the gown
2. Identify the sleeve opening and hold gown
away from you allowing it to unfold
3. Slide the arms partway to the sleeves, hand
remaining inside the cuffs
4. Using a closed cuff technique but on your
sterile gloves
5. Circulator will reach in and tie the gown and
adjust, sila din maghahanap nung waist tie and
mag straighten non
6. Final step is called turning, hand yung turning
card sa circulator (eto yung may cardboard
dapat hindi ka na mahahawakan nung
circulating nurse kasi sterile ka na so sa
cardboard din ang hawak niya)
1. Lay the drying towel over the outstretched
hands to the person scrubbing in
2. Grasp the gown near the neckband
3. Arms holes dapat nakaharap sa susuotan
4. Show the inside of the gown and allow them to
slip their arms into the sleeves
5. Stretch open the glove cuff so they can insert
their hand w/o touching you
6. Make sure na ipapakita mo yung sa may
thumb na part sa glove para tama yung
pagkakapasok ng kamay nila
7. Kapag nag glove dapat ang position ng paa
ganto para ma-maintain yung balance
 STERILE

• Free of living microorganisms, including

spores
• 0% talaga
ASEPSIS

• Absence of disease producing microogranisms

8. Insert na yung hand, make sure na walang • Decrease the possibility of transmitting disease
mahahawakan na non sterile 1. MEDICAL ASPESIS
9. Repeat lang sa kabilang hand, pero dito pwede - Used to reduce the number of microbes
niya na gamitin yung naglove na hand para and prevent spread
istretch yung gloves pa para mapasok niya ng - “clean”
Madali lang 2. SURGICAL ASEPSIS
- Right hand first then left - Use to eliminate any microorganisms
10. Then ayun, itatie na ulit ni circulator yung mga (sterile technique)
tie - Intended free of all microorganisms
11. May turning ulit
DISINFECTION
TURNING
• The process of killing the pathogenic
- Eto yung final step sa preparation ng microorganisms
surgical gown • Lacks sporicidal power
- Purpose: Encircle the scrub with the sterile
gown
1. Waist tie is separated from the gown and the
tie card is passed to the circulating nurse
2. Circulator, remains in place while you turn
3. After turning, ipupull mo yung tie sa card then
isesecure mo na
GLOVING
OPEN METHOD
- Used for procedure which does not require
gowns such as cather and wound care
OR 3 ZONES
CLOSED GLOVE CUFF METHOD
• UNRESTRICTED – street clothes
- During surgical procedure
- Worn after wearing the surgical gown • SEMI-RESTRICTED – scrub suit and cap
- Establishing initial sterile field by the • RESTRICTED – scrub suit, cap, mask, shoe
scrub nurse covers, gloves
- Assurance against contamination because
no bare skin is exposed in the process of
wearing the gloves kasi the hands does not
extend sa cuff ng gown
- Panoorin niyo nalang para magets niyo
- Basta tsaka niyo lang ilalabas yung kamay
niyo kapag yung cuff nakapasok na sa
gloves
STERILIZATION

• Consist of physical and chemical techniques

that destroy all microorganism including
spores
• Bacterial spores are the most persistent of all
living organisms