The Importance of Scrubbing In: Beyond Tradition and Hygiene in Surgery

Many people ask why surgeons have to scrub their hands before performing a procedure. Some believe it is a tradition, while others wonder about the necessity. However, the practice of scrubbing in is far from superfluous—it is a critical component of modern surgery that prioritizes hygiene and infection prevention.

Understanding the Tradition

When someone inquires about the origin and necessity of scrubbing in, the immediate response is often, “For the same reason you wash your hands after using the toilet, you shower every day, and before medical procedures.” Scrubbing in is about more than tradition; it is about ensuring that surgeons are as hygienic as possible before coming into contact with the patient. This is especially crucial in the context of antibiotic resistance.

Antibiotic Resistance: A Growing Threat

The rise of antibiotic resistance is a global health concern. Overprescribing antibiotics and using them in livestock to promote growth, rather than treating infections, has allowed tough bacteria to survive and create more resistant strains. This highlights the importance of minimizing the spread of bacteria, even during routine surgical procedures.

Surgical Scrubbing and Antibiotic Resistance

During surgery, every precaution is taken to prevent the spread of these antibiotic-resistant bacteria. Surgeons are sterilized and do not use any antibiotics, ensuring they do not inadvertently spread these resilient microorganisms. This practice is vital because, as Alison rightly pointed out, antibiotic-resistant bacteria are a significant and increasing problem in healthcare settings.

Hygiene and Modern Surgical Practice

From a hygiene perspective, scrubbing in is not just a mere formality—it is an essential step in ensuring that the surgeon's hands are free of contaminants. Other methods of hand cleaning, such as alcohol-based sanitizers, have been tested but have not consistently shown the same effectiveness as the thorough scrubbing with antiseptic solutions.

Surgical Gloves and Their Limitations

While surgical gloves are invaluable, they are not perfect. In fact, research indicates that surgical gloves fail to provide a complete barrier around 35% of the time. Double gloving can reduce this failure rate to 4%, but even then, there is still a risk of exposure to bacteria. This highlights the importance of thorough hand scrubbing as an additional layer of protection.

Conclusion

Scrubbing in is not a traditional ritual, but a critical safety measure in modern surgery. It is an essential part of maintaining high standards of surgical hygiene and preventing infections, especially in the face of rising antibiotic resistance. The practice serves a dual purpose: it protects the patient from harmful microorganisms and prevents the surgeon from potentially spreading bacteria.

So, the next time someone questions the importance of scrubbing in, it’s worth explaining the serious health and safety implications. This practice is not optional; it is a foundational element of ensuring surgical integrity and patient safety.