No longer a happy scrubber

Re: No longer a happy scrubber

Mark Holmes — Tue, 04 Dec 2012 21:13:32 GMT

[quote user="Martin Atkinson"]

[quote user="Evelyn Barbour-Hill"]

It's easy to put gloves on, they are not expensive, they provide a sterile surface instead of your highly unsterile skin: they may not be vitally important, but why not use them anyway?

[/quote] Because I lose touch and grip and I think I'm a better surgeon without them, besides half the time they rip anyway. The only time I wear them is to protect me from the patient if its something grotty like a foul dental!

[/quote] All rubbish. I used to work naked I now wear gloves. Wouldn't go back. To be able to get the fat and grease of your hands instantly without having to scrub again after the surgery is delightful and you get to flick them into the bin in a cool and demigodly fashion ;-)

Re: No longer a happy scrubber

Evelyn Barbour-Hill — Tue, 04 Dec 2012 19:14:02 GMT

[quote user="Martin Atkinson"] Because I lose touch and grip and I think I'm a better surgeon without them,[/quote]

I guess most people say that until they have actually tried.

[quote user="Martin Atkinson"]besides half the time they rip anyway.[/quote]

Well if you will buy cheap and nasty gloves.....................

Re: No longer a happy scrubber

Martin Atkinson — Tue, 04 Dec 2012 17:59:51 GMT

[quote user="Evelyn Barbour-Hill"]

It's easy to put gloves on, they are not expensive, they provide a sterile surface instead of your highly unsterile skin: they may not be vitally important, but why not use them anyway?

Re: No longer a happy scrubber

Evelyn Barbour-Hill — Tue, 04 Dec 2012 17:47:59 GMT

It's easy to put gloves on, they are not expensive, they provide a sterile surface instead of your highly unsterile skin: they may not be vitally important, but why not use them anyway?

Re: No longer a happy scrubber

Martin Atkinson — Tue, 04 Dec 2012 17:31:59 GMT

[quote user="Dagmar Steele"]

[quote user="Martin Atkinson"]

At risk of hijacking the OP (I use chlorhexidine routinely, nurses use Pevidine though as they're sensitive to chlorhex.) I wash my hands tor a minute or less and do a 10 second nail scrub. I don't wear gloves, a mask, a silly hat, sterile gown or overshoes and nor does anyone else and I don't get wound infections - what am I doing wrong?

[/quote]

You're doing nothing wrong :-) (Apart from that you might be in trouble for not wearing gloves if you get the first wound infection!) At the same lecture they said the smaller the practice the less the risk of wound infections, nosocomial infections and so on. He said (although jokingly): "If you have only ten patients a day you may as well operate on your kitchen table, it won't make a change." It's all about contamination I guess - the more traffic the more germs.

[/quote] It was of course a rhetorical question, I am clearly doing no wrong and I think my record would be defence enough if someone did take me to task over a wound infection. I have no doubt that the greater the number of bodies in the theatre, the more hands in the wound, the longer the op takes and the less skilful the surgeon the greater the risk. But the biggest factor of all is how well you prep the patient or how how well it is possible to prep the patient. It is probably contributing 99% of the potential bugs into the scenario, a 5 minute scrub and all the sterile gear in the world is worthless if you don't get that bit right.

Re: No longer a happy scrubber

Rob Watkins — Tue, 04 Dec 2012 16:24:38 GMT

There has been a large culture change in the human side... You, the patient are viewed as the contamination risk to the hospital, healthcare workers and other patients. So yes, if you see a couple of patients a day the risk of you getting wound infections is reduced considerably.

Re: No longer a happy scrubber

Dagmar Steele — Tue, 04 Dec 2012 15:47:05 GMT

[quote user="Martin Atkinson"]

[/quote]

Re: No longer a happy scrubber

Evelyn Barbour-Hill — Tue, 04 Dec 2012 14:47:47 GMT

[quote user="patrick murphy"]

NHS guide says still scrub 2 minutes and UP TO THE ELBOW , why when you put on a gown?

[/quote]

If you swear you scrub up to the elbow, there's a reasonable chance you will get your hands clean to somewhere just above the wrist.

Re: No longer a happy scrubber

Martin Atkinson — Tue, 04 Dec 2012 14:40:13 GMT

[quote user="Dagmar Steele"]Honestly, last lecture I went to a fortnight ago they were really not into brushing hands. They even had a doc in from an university hospital for humans and they don't brush if no gross dirt is visible either. Anyone wearing overshoes in theatre? They don't like these either, say they blow the germs right into the room with every step you take ![/quote] At risk of hijacking the OP (I use chlorhexidine routinely, nurses use Pevidine though as they're sensitive to chlorhex.) I wash my hands tor a minute or less and do a 10 second nail scrub. I don't wear gloves, a mask, a silly hat, sterile gown or overshoes and nor does anyone else and I don't get wound infections - what am I doing wrong?

Re: No longer a happy scrubber

Gillian Mostyn — Tue, 04 Dec 2012 14:18:51 GMT

for the same reason you scrub your hands even though you are wearing gloves I guess.......!!

Re: No longer a happy scrubber

patrick murphy — Tue, 04 Dec 2012 13:09:41 GMT

NHS guide says still scrub 2 minutes and UP TO THE ELBOW , why when you put on a gown?

Re: No longer a happy scrubber

Adrienne McPartland — Sun, 02 Dec 2012 21:43:39 GMT

Yes it is alcohol based, and I would normally have issues with constant alcohol rubs also, but don't have problems with sterilium.

http://www.bode-chemie.com/products/hands/sterillium.php

Chlorhexidine not only destroys my skin but I come out in a really severe rash, with itching and uriticaria.

Re: No longer a happy scrubber

CatherineThomas — Sun, 02 Dec 2012 21:40:21 GMT

[quote user="Adrienne McPartland"]

+1 For sterilium.

Initial scrub of the day was with hibiscrub and then each subsequent with Sterilium, 90 seconds contact time and the lack of needing to scrub real helps your hands. Only thing is if you have any cuts it stings like crazy !

[/quote]

Is this an alcohol based hand steriliser? I have sensitive skin but I'm fine with both hibiscrub and pevidine. But any of the alcohol based products make my hands sore and scaley. Even the repeated washing after every consult is better than using an alcohol rub.

Re: No longer a happy scrubber

Adrienne McPartland — Sun, 02 Dec 2012 19:51:07 GMT

+1 For sterilium.

Re: No longer a happy scrubber

Michael Woodhouse — Sun, 02 Dec 2012 11:19:09 GMT

Oh and make sure you dry your hands properly after scrubbing. Moist skin in gloves is never good.

Re: No longer a happy scrubber

Richard Huddart — Sun, 02 Dec 2012 10:15:19 GMT

We use hand washing with Sterilium now - great for the hands. Just a proper scrub at beginning of the day to remove oil/mud/cheese etc, then 90 seconds contact time with sterilium. None of our sensitive skinned people complained yet!

Re: No longer a happy scrubber

Busybee — Sat, 01 Dec 2012 20:33:34 GMT

[quote user="Liz white"]I was going to suggest the body shop's hemp hand cream.

[/quote]

+1 for this! I love this hand cream - seems to be the only one to sort out my poor sore cracked hands!

Re: No longer a happy scrubber

bob lehner — Sat, 01 Dec 2012 20:02:47 GMT

Sheep intestine for the poor - latex for the better off.

Re: No longer a happy scrubber

Chris Geddes — Sat, 01 Dec 2012 18:39:36 GMT

Were non-latex versions not available then?! Or just too expensive for students? :P

Re: No longer a happy scrubber

bob lehner — Sat, 01 Dec 2012 16:34:29 GMT

[quote user="Chris Geddes"]I guess one way to tell would be if you wear latex products anywhere else, but I wouldn't like to ask :-0[/quote]

I well remember a pal at university who became very depressed when his girlfriend suddenly developed a latex allergy.

Re: No longer a happy scrubber

Michael Woodhouse — Sat, 01 Dec 2012 15:50:23 GMT

About a month ago I was in our op theatre in wellies with a farmer in his and a fitting collie dog.

Floor mopped and table cleaned as normal but nothing special.

Re: No longer a happy scrubber

Evelyn Barbour-Hill — Sat, 01 Dec 2012 15:47:22 GMT

[quote user="Dagmar Steele"][quote user="Evelyn Barbour-Hill"]

[quote user="Dagmar Steele"] brush only needed if grime under the fingernails :-)[/quote]

There is always grime under the fingernails

[/quote] True, I should have written visible grime ;-) Honestly, last lecture I went to a fortnight ago they were really not into brushing hands.[/quote]

On the contrary, what I meant, if we are going to get serious, is that in my opinion there is always heavy contamination under the fingernails, and round the "cuticles" and in any other cracks and crannies, whether it's visible to a cursory naked-eye inspection or not. In my philosophy the object of scrubbing is to remove the superficial crud . Since gentle scrubbing does no harm anyway, I will continue to scrub.

No to overshoes, but shoes worn into the op room (which I decline to call, grandiosely, "theatre") must be dedicated indoor shoes and never worn in the street. But no clogs, of which I cannot see the point, or "scrubs" (I cannot see how ill-fitting, faintly obscene garments exposing quantities of flesh somehow improve hygiene ).

Re: No longer a happy scrubber

Dagmar Steele — Sat, 01 Dec 2012 13:17:14 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Dagmar Steele"] brush only needed if grime under the fingernails :-)[/quote]

There is always grime under the fingernails

[/quote] True, I should have written visible grime ;-) Honestly, last lecture I went to a fortnight ago they were really not into brushing hands. They even had a doc in from an university hospital for humans and they don't brush if no gross dirt is visible either. Anyone wearing overshoes in theatre? They don't like these either, say they blow the germs right into the room with every step you take !

Re: No longer a happy scrubber

Evelyn Barbour-Hill — Sat, 01 Dec 2012 12:59:30 GMT

[quote user="Dagmar Steele"] brush only needed if grime under the fingernails :-)[/quote]

There is always grime under the fingernails

Re: No longer a happy scrubber

Simon Neuhoff — Sat, 01 Dec 2012 10:17:02 GMT

[quote user="Chris Geddes"]

I guess one way to tell would be if you wear latex products anywhere else, but I wouldn't like to ask :-0

Apparently babies who have a lot of surgery develop allergy too due to surgeons' hands...

If you have a serious allergy the whole theatre team will wear non-latex gloves for you.

[/quote]

Chris currently my only exposure to latex is surgical or examination gloves...... ;-) I used to have more exposure - I am of course referring to the seals on my drysuit from my scuba diving days!