Refolding a Reusable Cloth Surgical Gown for Packaging and Sterilization

Proper folding helps:

• Protect the gown during handling.

• Facilitate efficient wrapping.

• Promote effective steam penetration during sterilization.

• Allow organized opening and donning during subsequent use.

A well-folded gown should be

compact without being compressed excessively.

Students should avoid: when folding a gown

• Folding damp gowns.

• Ignoring damaged cuffs, seams, or ties.

• Leaving ties protruding from folds.

• Twisting sleeves during folding.

• Creating bulky or uneven folds.

• Compressing the gown excessively.

• Allowing cuffs to remain exposed.

• Folding gowns on dirty surfaces.

If the gown becomes: contaminated what should we do

• Stop the process.

• Correct the issue if possible.

• Refold the gown before wrapping.

• Remove damaged gowns from service.

Key Points for Students when we are dealing with refolding a reusable cloth surgical gown

• Only clean, dry gowns should be prepared for sterilization.

• Inspect the gown before every folding procedure.

• Ties and sleeves should remain fully contained within the folds.

• Fold the gown into a neat rectangular package.

• Protect cuffs from damage and exposure.

• Proper folding makes wrapping and aseptic presentation easier.

• A standardized folding technique promotes consistency within the surgical team.

Key Points for Students in downing and gloving

• Sterility is maintained by touching sterile items only with sterile surfaces.

• Keep hands above waist level, below the shoulders, and in front of the body.

• Do not allow hands to emerge from sleeves until sterile gloves are donned.

• The front of the gown is sterile; the back is not.

• If contamination is suspected- touch nothing, re-gown and/or re-glove immediately.

If contamination does occur during the gowning and gloving what should one do

1. Notify the supervising surgeon or instructor immediately.

2. Step away from the sterile field.

3. Replace the contaminated gown according to hospital policy.

4. Re-gown and re-glove before returning to the procedure.

The following areas are considered non-sterile:

• Neckline

• Shoulders

• Axillary regions

• Back of gown

• Areas below table level

• Cuffs before sterile gloves are donned

What are some common errors for gowning

• Allowing hands to protrude from sleeve cuffs before gloving

• Touching the outside of the gown during donning

• Dropping hands below waist level or raising them above shoulder height

• Turning their back toward a sterile field

• Reaching over non-sterile surfaces

• Allowing the gown to contact non-sterile objects

The following portions of the gown are considered most sterile

• Front of gown from shoulders to level of sterile field/your waist.

• Sleeves from approximately 2 inches (5 cm) above the elbow to the cuff

Maintain Asepsis Following Hand Preparation Following completion of either protocol:

Keep hands above elbows and away from the body.

When moving between during hand scrubbing

• Hold your hands in front of your chest.

• Keep hands visible at all times.

Where should hands be kept when doing hand scribs

Hands should remain above waist level and below shoulder height.

What should we avoid touching when we are done hand scrubbing

• Clothing

• Masks

• Eyewear

• Hair

• Equipment

• Environmental surfaces

Proceed directly to gowning and gloving.

The purpose of surgical hand antisepsis is to:

• Remove transient microorganisms.

• Reduce numbers of resident microorganisms.

• Inhibit microbial growth during surgical procedures.

The purpose of After antisepsis:

• Hands are surgically prepared but not sterile.

• Sterility is achieved only after appropriate sterile gowning and gloving procedures.

Any contact with a non-sterile item may what

compromise preparation and require repetition of the process.

What are the common errors that can occur in hand scrub or rub

• Wearing jewelry during hand preparation.

• Skipping nail and fingertip cleaning.

• Allowing hands to fall below elbow level during rinsing.

• Touching the sink or faucet.

• Inadequate scrub duration.

• Inadequate product contact time when using surgical hand rubs.

• Applying alcohol-based products to wet hands.

• Touching non-sterile surfaces after hand preparation.

• Failing to proceed directly to gowning or gloving.

If a contamination does occur in hand scrubbing or rubbing

• Notify the supervising clinician or instructor.

• Step away from the sterile field.

• Repeat surgical hand antisepsis according to hospital policy.

• Reinitiate gowning and gloving procedures as necessary.

What are the advantages of Traditional Surgical Scrub

• Physically removes dirt and debris.

• Familiar technique in many institutions.

• Appropriate when hands are visibly soiled.

What are the disadvantages of Traditional Surgical Scrub

• Requires water access.

• More time consuming.

• May contribute to skin irritation when frequently performed.

What are the advantages of using Alcohol-Based Surgical Hand Rubs

• Rapid application.

• Excellent antimicrobial activity.

• Often associated with improved skin tolerance.

• Reduced water usage and towel waste.

What are the limitations for using Alcohol-Based Surgical Hand Rubs

• Hands must be clean and free of visible contamination before use.

• Requires strict adherence to manufacturer instructions.

• Product must be allowed to dry completely.

What are the key points when dealing with hand scrubbing or rubbing

• Remove jewelry before beginning.

• Fingertips and nails receive the greatest attention during hand preparation.

• Keep hands above elbows following antisepsis.

• Hands are surgically prepared but not sterile after scrubbing or hand rub application.

• Proceed directly to gowning and gloving.

• If contamination is suspected, repeat the preparation process.

• Slow, consistent technique is more important than speed.

What are the key points of doing open gloving

• Only touch the inside cuff of the first glove with your bare hand.

• Only touch the outside cuff of the second glove with your gloved hand.

• Once gloved, sterile surfaces must only contact other sterile surfaces.

• Keep gloved hands in sight and in front of and away from your body.

• If contamination is suspected, remove and replace the gloves immediately.

• Slow, deliberate movements help maintain sterility.

Open gloving may be appropriate for:

• Minor sterile procedures.

• Catheter placement.

• Wound management.

• Sample collection requiring aseptic technique.

• Replacing contaminated gloves during some procedures.

• Situations where sterile gowning is not required.

Open gloving is generally not appropriate when

sterile gowning is required for entry into a surgical field.

The following areas are considered sterile:

• Exterior surfaces of properly donned sterile gloves.

• Sterile inner packaging surface intended as the sterile field.

The following areas are considered non-sterile:

• Bare hands.

• External glove packaging.

• Clothing and scrub attire.

• Skin of the forearms and wrists.

• Environmental surfaces not specifically prepared as sterile.

What are the common errors for open gloving

• Touching the exterior surface of the first glove with bare fingers.

• Touching the inside surface of the second glove with a sterile gloved hand.

• Allowing gloves to contact clothing.

• Donning gloves with wet hands.

• Reaching across the sterile field unnecessarily.

• Adjusting glasses, masks, phones, or other personal items after gloving.

• Touching non-sterile surfaces once gloves have been donned.

If contamination does occur what should we do in open gloving

• Stop immediately.

• Notify the supervising veterinarian or instructor if applicable.

• Remove contaminated gloves.

• Open a new set of sterile gloves or ask an assistant for help with this step.

• Perform hand hygiene if necessary.

• Repeat the gloving procedure.