The LSUHSC New Orleans Emergency Medicine Interest Group Presents The Student Procedure Manual

Surgical Attire

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 suite.
  
  • Scrub clothes should be laundered between wearings or discarded after wearing if disposable.
    
  • 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.
  
  • Masks should cover both mouth and nose and be secured in a manner that prevents venting.
    
  • 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.