why do surgeons bother scrubbing all the way up to their elbows, but then it is covered by sleeves and gloves?
In: Biology
As others have mentioned gloves and gowns are not perfect, especially when it comes to moisture. Strikethrough happens when fabric is saturated, your sweaty arms after a 6 hour case wearing lead, or doused with blood/amniotic fluid etc. There are ‘levels’ of permeability to gowns based on what you expect during the surgery, but who’s to say there isn’t a tiny defect in that sleeve you couldn’t see?
Not to mention the chance that a glove tears. It’s good practice to double glove or wear a thicker pair anytime you don’t need optimal finger sensation/dexterity. But it’s not uncommon working with broken bones or even tying heavy suture that you notice a hole in your thumb.
The primary cause of surgical site infections is the patient’s own skin. That is why you prep the area with a cleansing solution that varies based on a multitude of factors. But just like a hand scrub, skin can never be sterile – only surgically clean. It’s about minimizing risks to near zero.
There are several factors to infection, but hygiene is all about the level of inoculation. Contaminating a wound with 1000 bacteria is less likely to get infected tham 1000000 bacteria.
Dilution is always the solution. Irrigating wounds also helps to prevent there from being a concentrated pathogen that will multiply quicker than the body can fight it off.
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