The LSUHSC New Orleans
Emergency Medicine Interest Group
The Student Procedure Manual
Purposes and Principles
The recommended practices provide guidelines for attire worn within the
semirestricted and restricted areas of the surgical environment. The human
body is major source of microbial contamination in this environment. Surgical
attire, which may include scrub clothes, hair covering, masks, protective
eyewear, and other protective barriers, provide a barrier to contamination
that may pass from personnel to patient as well as from patient to personnel.
Surgical attire is worn to promote high level cleanliness and hygiene within
the surgical environment. These recommended practices are not intended to
address sterile attire worn at the operative field.
All persons who enter the semirestricted and restricted areas of the surgical
suite should be in surgical attire intended for use only within the surgical
Scrub clothes should be laundered between wearings or discarded after wearing
Scrub clothes should be changed whenever they become visibly soiled or wet.
Scrub clothes should not be worn when leaving the surgical environment. If
this is not attainable, use a cover gown or lab coat.
Surgical attire design and composition should minimize bacterial shedding.
When a two-piece scrub suit is worn, loose fitting tops should be tucked into
the trousers. Tunic tops which fit close to the body may be worn outside the
trousers. Nonscrubbed personnel should wear long-sleeved jackets. The jackets
should be buttoned or snapped closed during use. People are the major source
of environmental contamination in the surgical suite. Research indicates that
chafing increases dispersal of body scurf.
Shoe covers, are changed whenever they become tom, wet, or soiled.
All possible head and facial hair, including sideburns and neckline, should
be covered when in the semi-restricted and restricted area of the surgical
suite. Hair and dander are a major source of particulate that carry bacteria.
All persons entering the restricted areas of the surgical suite should wear
Masks should cover both mouth and nose and be secured in a manner that prevents
Masks should be removed and discarded after use. During use, masks become
wet and laden with microorganisms.
All personnel entering the semirestricted and restricted areas of the surgical
suites should have all jewelry confined or removed.
Nail polish and artificial nails should not be worn within the semirestricted
and restricted areas.
Protective barriers should be made available to reduce the risk of exposure
to potentially infective materials.
Gloves should be selected and worn depending on the task to be performed.
Sterile gloves should be worn, when performing sterile procedures; unsterile
gloves may be worn for other tasks. Gloves should be changed between patient
contacts or after contact with contaminated items when the task is completed.
Surgical or examination gloves should be changed (not merely washed) between
patient contacts. Hands should be washed after removing gloves.
Protective eyewear or face shields should be worn whenever activities could
place one at risk for a splash to the face or eye.
Protective eyewear or face shields that become contaminated should be discarded
or decontaminated as promptly as possible according to manufacturer's recommendations.
Additional protective attire such as fluid-resistant aprons, gowns, and shoe
covers should be worn when contact with blood or body fluids is unavoidable.
Shoes that provide protection should be worn within the surgical environment.