5.5 Operating Room Protocols and Infection Control

Before the first protocol of the day, all surgical colleagues who will work in the operating room should scrub their arms and hands with an antiseptic agent for at least two minutes. A deep cleaning beneath fingernails should be included in the first scrub of the day.

Jewelry must be removed, and artificial nails must not be worn as they are associated with enhanced bacterial colonization on the hands.

The surgical team should keep their hands away from the body after conducting the surgical hand hygiene so that the water runs from the hands to the elbows.

Each team member must wear high-quality sterile gloves. In orthopedic surgery, where 50 percent of gloves are punctured, wearing two pairs of gloves is recommended, especially during solidified total joint orthopedic surgeries. Double-gloved surgery may also help to safeguard the medical team from infection.

After any inadvertent puncture, gloves should be changed right away. After draping, some specialists advise switching the outer gloves regularly, as this procedure is known to contaminate gloves.

A detergent should be used to scrub the surgical site, and an antiseptic soap should be applied. For wound dressing, alcohol solutions are preferred over aqueous solutions, but the alcohol must be allowed to dry after application and before mechanical stimulation.

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