Presentation on theme: "Entering the Sterile Field: Scrubbing, Gowning, and Gloving"— Presentation transcript:
1Entering the Sterile Field: Scrubbing, Gowning, and Gloving Concorde Career College
2Entering the Sterile Field Objectives:State the purpose of performing the surgical scrub, list the steps of the surgical scrub utilizing the counted brush stroke method, and explain the related sterile concepts.Describe the technique utilized when drying and gowning oneself and explain the related sterile concepts.Describe the technique utilized when closed gloving and explain the related sterile concepts.
3Entering the Sterile Field Objectives:Describe the technique utilized when assisting a team member with gowning and gloving and explain the related sterile concepts.Describe the technique utilized when removing and replacing the gown and gloves intraoperatively and explain the rationale.Describe the technique utilized when removing the gown and gloves postoperatively and explain the rationale.
4Practices in Sterile Technique Surgical ScrubAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
5MethodTraditionally, both timed and counted brush stroke methods have been usedThe method demonstrated is the counted brush stroke method
6Please Note the Following Recent studies suggest that the use of alcohol solutions may be as or more effective than traditional scrub solutions.More studies are warranted.
7Preparation for the Surgical Scrub Attend to personal needsDon all personal protective equipmentTear open the packet containing the scrub brushAdjust water temperature if necessary
8Scrubbing: Step 1Hands and arms should be visually inspected for wounds or infections of any type
9Scrubbing: Step 2Nails and cuticles, also, should be carefully inspected
10Scrubbing: Step 3Apply water to the arms for the pre-scrubhand-wash
12Scrubbing: Step 5 Perform a 30 second standard handwash Rinse from finger tips to elbows
13Scrubbing: Step 6 Secure the previously opened scrub brush Reapply antimicrobial solutionRemove the nail cleaner
14Scrubbing: Step 7 Clean each nail thoroughly under running water Note: You will need to hold the brush at the same time you are cleaning the nails
15Scrubbing: Step 8Rinse the end of the nail cleaner after each nail
16Scrubbing: Step 9 Discard the nail cleaner into the waste receptacle Add an antimicrobial solution to the brush if necessary or wet and squeeze brush if it is soap impregnated
17Scrubbing: Step 10 Begin with scrubbing the nails Use 30 strokes 1 stroke is the combined movement in both directions
18Scrubbing: Step 11 Scrub all fingers 10 strokes per plane per digit (Planes = superior, medial, lateral, inferior)Scrub web between fingers
19Scrubbing: Step 12 Continue to scrub the hand covering all planes Continue proximally along the arm, scrubbing 1/3 the arm at a timeKeep arms away from scrub top and other objects
20NoteWhile several different practices are used, we recommend scrubbing one hand and arm completely, changing the brush to the other hand, and repeating the process with the second hand and arm.
21Scrubbing: Step 13When scrub of both arms is completed, drop brush into waste receptacleKeep arms away from the bodyRinse from finger tips toward elbowNote blue path of water run-off
22Scrubbing: Step 14 Rinse arms thoroughly using a dipping maneuver Note all the environmental dangersKeep arms outNote the blue path of water run-off
23Practices in Sterile Technique Drying the Hands and ArmsAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
24Step 1Watch the sterile field and verify that no water drops fall onto the sterile field from wet handsReach directly to the center of the towel and grasp it firmly
25Step 2 Lift the towel directly from the Mayo stand Step back as the towel is lifted
26Step 3 Bend at the waist Unfold the towel Maintain distance from sterile fieldsUse one end of the towel
27Step 4 Be aware of the lower ends of the towel Begin to dry the hand at the fingers working toward the elbow
28Step 5Rotate the hand and arm being dried to ensure that all surfaces are contactedUse a squeezing and/or patting motion with the towel handWatch the lower end of the towel
29Step 6 Stop drying the first arm at the elbow Place the dry hand on the sterile end of the towel (unused part)
30Step 7Reverse the ends so that the contaminated / wet end is now the lower end
31Step 8 Repeat the process on the second hand When finished drying, do not regrasp or refold the towelDrop the towel into the linen hamper without changing hand positions on the towel
32Practices in Sterile Technique Putting on a GownAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
33Gowning: Step 1 Observe the placement of various sterile fields Approach the Mayo stand with gown and gloves opened upon itKeep your body away from the sterile fieldReach from above down to the gown
34Gowning: Step 2 Reach directly onto the gown Avoid touching the glove package or gown wrapping“Pinch” the gown, controlling all layers
35Gowning: Step 3 Lift the gown vertically from the Mayo stand Keep your body away from the Mayo stand
36Gowning: Step 4Once the gown is lifted from the sterile field, step back from the Mayo standBeware other sterile fields and do not back into them
37Gowning: Step 5 Identify the collar of the gown Confirm that the gown is oriented properly - inside of gown facing toward youGrasping the gown at the collar and sleeves, release the lower portion
38Gowning: Step 6 Identify the arm openings Place one hand inside each openingMove hand into the sleeveRemain conscious of all items around you
39Gowning: Step 7 Slip the first arm into the sleeve Stop before the hand reaches the edge of the cuffFlexing the arm slightly will help hold the gown in placeRepeat on other side
40Gowning: Step 8Stop the second arm movement before the hand reaches the edge of the cuffFlex both arms to hold the gown in placePrepare to put on gloves
41Donning a Surgical Gown Donning a surgical gown requires some “big” movements; therefore the surgical technologist must have a heightened awareness of the total environment around her/him.
42Closed Glove Technique Gloving OneselfClosed Glove TechniqueAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
43Step 1 After gowning, approach the Mayo stand Hands should be contained within the gown sleeve and distal to linen cuffKeep distance between body and Mayo stand
44Step 2Be aware of the gown front and do not allow it touch the gown wrapperOpen the glove package with covered handsStop as soon as one glove is exposed
45Step 3 Lift first glove from glove package by the cuff of the glove Place it on the hand to be gloved so that the edge of the glove cuff is at the union of gown and cuffPalm to palm; thumb to thumb
46Close-up ViewCuff to cuffPalm to palmThumb to thumb
47Step 4Grasp lower edge of glove cuff with fingers on the hand being coveredGrasper upper edge of glove cuff with fingers of other handStretch and extend the glove cuffRoll wrist of hand being covered so glove cuff covers the linen cuff of the gown
48Step 5 Be sure glove covers all of the gown cuff Do not touch gown cuff with other handExtend fingers into glove fingersPull glove onto hand
50Step 7Note: always step back from the Mayo stand in order to perform gowning and gloving tasksComplete gloving process
51Practices in Sterile Technique Turning a Wrap-around GownAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
52Turning a wrap-around gown Most gowns are designed to wrap around the person working in the sterile field. The practices described should be used for all gowns turned. No one should turn their back to the sterile field while the gown is being turned.
53Turning: Step 1Grasp the tab in the right hand and the tie in the left handSeparate the twoHand the distal end of the tab to the circulatorTo avoid contamination watch the circulator’s hand as you make the exchange
54Turning: Step 2The circulator moves the tab behind the gowned person, keeping the “tie” extendedThe gowned person rotates the shoulders to the left in order to receive the “tie”Beware of other sterile items
55Turning: Step 3While rotating the shoulders to the left, transfer the tie held in the left hand to the right hand
56Turning: Step 4Circulator continues circling the gowned person, keeping the tie extendedBoth parties observe areas of potential contamination
57Turning: Step 5Gowned person takes the tie, NOT the TAB, from the circulatorCirculator keeps and discards the tab
58Turning: Step 6 The ties are secured The gowned person should maintain appropriate distance from the other sterile areas until the gown is completely secured
59Assisting Other Team Members Gowning and Gloving AnotherAsepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
60Handing a Towel to an Unsterile Team Member Maintain safe distanceAllow the unsterile team member to reach out into neutral zoneKeep towel close to body until ready to hand
61Handing a Towel to an Unsterile Team Member Open the towelKeep hands spread and towel taut at the topKeep hands away from unsterile team member’s hands
62Handing a Towel to an Unsterile Team Member Keeping your hands spread, place the towel across the unsterile team member’s handsApply slight pressure so the unsterile team member can feel the towel in his/her handUnsterile team members dries hands and arms and discards towel into linen hamper
63Gowning the unsterile team member Maintain a safe distanceBe aware of the position of the unsterile team member’s hands
64Gowning the unsterile team member Allow the bottom of the gown to unfold toward the floorHold the gown near the neck line
65Gowning the unsterile team member Spread the gown so the unsterile team member can identify the sleeve entrancesCuff the neck of the gown over your hands to protect them from contamination
66Gowning the unsterile team member Allow the unsterile team member to place both arms in the sleeve entrances
67Gowning the unsterile team member Once the unsterile team member’s arms are well started in the sleeve, step back and remove your hands from the gown
68Gloving the unsterile team member Maintain a safe distanceUnfold the cuff of the first glove
69Gloving the unsterile team member Orient the glove so the palm faces the team member to be glovedUnfold the cuff of the gloveRefold the cuff over your fingers to protect your hand
70Gloving the unsterile team member With the fingers of both hands protected under the cuff, pull laterally opening the glove for the other team member
71Gloving the unsterile team member Repeat steps for the other handAllow the team member to help open the glove with his/her sterile hand
72Gloving the unsterile team member Release the glove after the cuff of the gown is completely covered
73Practices of Sterile Technique Disrobing with a contaminated gown(Technique used when re-gowning and gloving during a procedure)Asepsis and Sterile Technique is the third publication in the educational library of the Association of Surgical Technologists. Visit for more information about AST and their educational resources.
74Disrobing: Step 1The sterile person stands with her/his back to the circulatorThe circulator wears non- sterile glovesKeeping appropriate distance from the gown, the circulator unfastens top of the gown
75Disrobing: Step 2Continuing to maintain a safe distance, the circulator unties the inside back tie
76Disrobing: Step 3 The gowned team member turns to face the circulator Care is taken not to touch the circulator with the hands or front of the gownThe circulator grasps the contaminated gown at the shoulders
77Disrobing: Step 4The circulator pulls the gown forward and down over the armsBoth team members watch the gown carefullyGloves will normally role slightly at the cuff
78Disrobing: Step 5The gloves are presented to the circulator with the palms turned upCirculator grasps gloves by pinching the palmar surface of the gloves
79Disrobing: Step 6 The gloves are pulled forward slowly over the hands Care is taken not to snap the gloves and produce airborne debris or contaminates
80Disrobing: Step 7As the gloves are removed, the hands are moved away from the circulatorGloves are placed in the proper contaminated receptacle