Principles of Sterile Technique

Gowning & Gloving in the OR

The principles of Sterile Technique are applied in various ways. If the principle itself is understood
the applications of it become obvious. Strict aseptic technique is needed at all times in the Operating
Room.
Principles of Sterile Technique
1. All articles used in an operation have been sterilized previously.
2. Persons who are sterile touch only sterile articles; persons who are not sterile touch only unsterile
articles.
3. Sterile persons avoid leaning over an unsterile area; non-sterile persons avoid reaching over a
sterile field. Unsterile persons do not get closer than 12 inches from a sterile field.
4. If in doubt about the sterility of anything consider it not sterile. If a non-sterile person brushes
close consider yourself contaminated.
5. Gowns are considered sterile only from the waist to shoulder level in front and the sleeves to 2
inches above the elbows.
1. Keep hands in sight or above waist level away from the face.
2. Arms should never be folded.
3. Articles dropped below waist level are discarded.
6. Sterile persons keep well within the sterile area and follow those rules from passing:
1. Face to face or back to back.
2. Turn back to a non-sterile person or when passing.
3. Face a sterile area when passing the area.
4. Ask a non-sterile person to step aside rather than trying to crowd past him.
5. Step back away from the sterile field to sneeze or cough.
6. Turn head away from sterile field to have perspiration mopped from brow.
7. Stand back at a safe distance from the operating table when draping the patient.
8. Members of the sterile team remain in the operating room if waiting for the case.
9. Do not wander around the room or go out in the corridors.
7. Sterile persons keep contact with sterile areas to a minimum.
1. Do not lean on the sterile tables or on the draped patient.
2. Do not lean on the nurses mayo tray.
8. Non-sterile persons when you are observing a case, please stay in the room until the case is
completed. Do not wander from room to room as traffic in the operating room should be kept as
a minimum. Patient privacy needs to be respected.
9. Keep non-essential conversation to a minimum.
10. The circulating nurse is in charge of the room if you have any questions, please refer them to
her, the supervisor or your instructor. Ask circulating nurse when it is an appropriate time to ask
questions so that explanations/rationale can be given.
Sterile Members
Surgeon
The surgeon is in charge of the surgical team. He or she is the person who performs the operation
and directs the activities of other members of the surgical team. Surgeons usually specialize in the
treatment of specific surgical conditions, like orthopedics or cardiac surgery. Becoming a surgeon
involves 4 years of college, 4 years of medical school, then 3 to 5 years of specialized residency.
Certified Surgical Technologist
The surgical technologist is responsible for the preparation of the sterile supplies, equipment and
instruments, then assists the surgeon in their use. The surgical technologist most frequently serves as
instrument handler, setting up the instruments, then passing them to the surgeon. Surgical
technologists also serve as second assistants, utilizing instruments to perform tasks such as retracting
incisions, cutting suture and manipulating tissue. With advanced training or education, some surgical
technologists act as first assistants. This role may also be preformed by another physician, a
physician assistant or a registered nurse. Becoming a surgical technologist involves 1 to 2 years of
college or specialized training.
Non Sterile Members
Anesthesiologist
The anesthesiologist is a physician who specializes in administering drugs to the patient so he or she
is pain free during the operation. They monitor the patients response to anesthesia.
Registered Nurse
The Registered Nurse role is generally that of the circulator. The circulator is responsible for the
patient care during the operation. He or she assesses the patient, assists the anesthesiologist,
completes operating room records and dispenses items to the sterile team. Becoming a nurse in the
operating room requires 2 to 4 years of college, then specialized training on the job to learn surgical
patient care.
Gowning and Gloving
If you are the scrub corpsman, you will have opened your sterile gown and glove packages in the
operating room before beginning your hand scrub. Having completed the hand scrub, back through
the door holding your hands up to avoid touching anything with your hands and arms. Gowning
technique is shown in the steps of figure 2-4. Pick up the sterile towel that has been wrapped with
your gown (touching only the towel) and proceed as follows:
1. Dry one hand and arm, starting with the hand and ending at the elbow, with one end of the towel.
Dry the other hand and arm with the opposite end of the towel. Drop the towel.
2. Pick up the gown in such a manner that hands touch only the inside surface at the neck and
shoulder seams.
3. Allow the gown to unfold downward in front of you.
4. Locate the arm holes.
5. Place both hands in the sleeves.
6. Hold your arms out and slightly up as you slip your arms into the sleeves.
7. Another person (circulatory) who is not scrubbed will pull your gown onto you as you extend
your hands through the gown cuffs.
To gown and glove the surgeon, follow these steps:
1. Pick up a gown from the sterile linen pack. Step back from the sterile field and let the gown
unfold in front of you. Hold the gown at the shoulder seams with the gown sleeves facing you.
2. Offer the gown to the surgeon. Once the surgeons arms are in the sleeves, let go of the gown. Be
careful not to touch anything but the sterile gown. The circulator will tie the gown.
3. Pick up the right glove. With the thumb of the glove facing the surgeon, place your fingers and
thumbs of both hands in the cuff of the glove and stretch it outward, making a circle of the cuff.
Offer the glove to the surgeon. Be careful that the surgeons bare hand does not touch your
gloved hands.
4. Repeat the preceding step for the left glove.
The two techniques of gloving:
1. Open Gloving
2. Closed Gloving