Handwashing is one of the crucial steps in everyday life. Now after Covid 19, the whole world now knows how important it is to keep our hands clean and sterilize them. But have you ever wondered how surgeons wash their hands? They are treating hundreds of people every day. So It is vital to keep themselves safe from microbial infections. Now let’s see how do surgeons wash their hands carefully before surgery.
Before the invention of Surgical gloves, appropriate disinfection was done. Usage of disinfection was first demonstrated by Joseph Lister and he found that disinfectants reduced surgical site infections.
During the 19th century, the Surgical specializing method consisted of washing hands with antimicrobial soap along with warm water and also using the brush. Even today, these methods are followed because of their high efficiency.
Purpose of surgical handwash
The main purpose of sterilizing hands before starting the surgery is to remove any kind of debris and transient microbes from the nail, hand, and arms.
Not only this, hand washing before surgery also helps to reduce the resident flora. It eventually stops the growth of bacteria.
Surgical hand wash is opposite to the normal hand wash. Another reason why surgeons wash their hands is, they have to wash off transient microbes.
Even though surgeons wear gloves, they may have some unnoticed punctures. Generally, our skin contains billions of bacteria. So, there is a lot of chance that bacteria could be released from the unnoticed punctures of the gloves and enter into the open wound.
Due to surgical hand wash, the growth of bacteria under the gloves can be completely stopped.
How do Surgeons wash their hands?
It is very important to sterile the hand and arms before starting surgery. One can not perform surgery without sterilizing their hands. It can lead to the unnecessary transfer of bacteria into open wounds. So, it is necessary to wash the whole hand thoroughly.
Scrubbing is an important method to get rid of microbes on the hand. Generally, the surgeons scrub their hands using two methods.
The first method is the numbered stroke method. In this method, the surgeons use a certain number of brush strokes which are specifically made for finger, palm, hand, and arm.
Now the second one is the timed scrub method. In this method, as the term says they use scrubs based on period. It can generally last about 3 to 5 minutes.
Let’s see about timed scrub in detail.
Remove Jewelry
Before starting surgery, Surgeons follow this method. They first remove all the jewelry that they wear. Because it could be lost during surgeries or sometimes this jewelry can end up in the body of the patients during surgery. So for this purpose, they have to remove all their jewelry.
Washing Hand and Arm
This is a fundamental step. Here, the surgeons must wash both their arms and hands using antimicrobial soap. They do not use normal soaps because it is not effective to get rid of microbes.
They only use hot water for sterilizing their hands. You may ask why they do not use cold water. Because cold water will prevent the soap from lathering. So it won’t eliminate the microbes from the hand. This is the reason why surgeons avoid washing their hands with cold water.
On the other hand, extremely hot water can damage their skin and it also dries out the skin which makes it hard to wash the hand within the recommended amount of time. So using the proper temperature of the water will help them to eliminate the microbes from their hands. After this, they will clean their nails using a nail file.
Timed Scrub
Once the above mentioned process is over, they will start timing and scrub their fingers in between the areas of the fingers and both sides of their hands for two minutes.
Once they finish scrubbing their hands, they move on to arms and start to scrub them. It is important to keep their hands above the arms because while washing, microbes from the arms could slide through the hand. So it is important to always maintain the hand level above the arms.
After this, they will wash each side of the arm to elbows for one minute. Once done, they will repeat the exact process on the other hand and arm.
Rinsing the hands and arms
After completing the above steps carefully, it is time to rinse the hand. They have to rinse their hands and arms carefully because microbes can slide from one area to another area.
Rinsing must be done in one direction only. They will start rinsing from fingertips to elbows. And also, surgeons should not move the arm through the water. Until they enter the operation theatre, they should hold hands above the elbows.
They need to make sure that water should not be splashed on the surgical instruments. Once they enter the operating theatre, they have to dry out their hands and arms using a sterile towel and aseptic techniques. Once done, the surgeons will wear their operating gown and sterile gloves.
Materials used for Surgical scrub
1) Liquid or foam Soap
These are the most common surgical scrubs and widely used items. These liquid or foam soaps are carefully formulated using common antimicrobial agents like Chlorhexidine gluconate (CHG), Iodophor, and Parachlorometaxylenol (PCMX). Another important thing to note is, these antimicrobial agents are very drying in nature. So repeated scrubbing using a scrub brush will damage the skin.
2) Scrub brushes and Sponges
Scrub brushes and Sponges are stuffed with the above-mentioned antimicrobial agents.
3) Brush free surgical scrub
Brush-free surgical scrub will use an antimicrobial agent and water without the use of any scrub brush.
Apart from these materials of surgical scrub, sterile towels and running water is essential.
Side effects of Scrubs
When the surgeon uses surgical scrub, it may cause skin irritation and dermatitis which is associated with hand antisepsis.
Surgical scrubbing is important for surgeons. By following a certain time, they have to finish this process. They also use alcohol-based sterilizers for washing their hands. So this is how surgeons wash their hands.