The LSUHSC New Orleans
Emergency Medicine Interest Group
The Student Procedure Manual
Purposes and Principles
These recommended practices serve as an outline for accomplishing the surgical
scrub. The surgical scrub is a necessary part of aseptic practice within the
operating room suite. Although sterile gloves are worn by the surgical scrub
team, the skin of their hands and forearms should be routinely degermed to
reduce the microbial flora in the event of glove failure.
The objectives of the surgical scrub are:
To remove soil and transient microbes from the hands and forearms.
To reduce the resident microbial count to as low a level as possible.
To inhibit rapid rebound growth of microbes.
All personnel should meet specified requirements prior to beginning the surgical
All jewelry should be removed from the hands and forearms.
Fingernails should be free of polish and trimmed short. Cuticles should be
in good condition.
Hands and forearms should be free of open lesions and breaks in skin integrity.
All personnel should be appropriately attired.
The antimicrobial soap or detergent should be effective.
An anatomical timed scrub or a counted brush stroke method should be used
for all surgical scrubs. The CDC recommended time is 5 minutes for a surgical
The anatomical timed scrub method allots a prescribed amount of time for
each anatomical area.
The counted brush stroke method allots a set number of brush scrub strokes
to each designated surface of the hands and forearms.
Open one sterile scrub brush.
Clean nails with "nail pic" under running water and scrub hands
and forearms to remove gross contamination; rinse hands and forearms.
Begin scrubbing the outside of little finger-left hand, and continue scrubbing,
progressing to the outside of thumb; ten (10) strokes per each surface area.
Scrub palm of hand using circular motion.
Close hand, scrub nails, then knuckles progressing to back of hand.
Repeat steps three (3) through (5) for right hand and forearm.
Discard brush and rinse hands and forearms keeping hands higher than elbows.
Be careful not to touch sink and/or fixtures.
Hold hands up and below eye level; elbows down and away from scrub clothes.