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Why Must Normal Flora Be Removed in a Surgical Scrub?

Before the 19th century, 25 percent of all pregnant women died after childbirth from a disease commonly called "child-bed fever." Now identified as a strep infection, the disease was spread from woman to woman because, at the time, doctors didn't wash their hands between patients. Today it's hard to imagine any doctor not scrubbing before attending a patient.

  1. Normal Bacteria on Human Skin

    • Healthy skin teems with bacteria, both good and bad microorganisms. On human skin, these are "normal flora." The healthy and harmful bacteria levels change depending on the skin's pH, moisture content and temperature. When health care workers wash their hands, the bacteria normally present on human hands are scrubbed off.

    Normal Hand Flora

    • There are many bacteria that make up the normal hand flora. Bacteria families such as staphylococci, streptococci and enterococci are often found on the hands. Candida, a yeast, and coreynabacteria and mycobacteria help to keep the damaging bacteria in check.

    Better Out Than In

    • The outer layers of skin are dead. These dead skin cells give the bacteria a place to live. But the bacteria don't thrive and multiply until they come into contact with living tissue. If the bacteria contacts living tissue through a minor cut, for example, a healthy immune system will reject them, but a compromised immune system may not be able to fend them off, leading to an infection.

    Surgical Sepsis

    • Placing hands with normal, healthy hand flora inside the body cavity exposes the bacteria to a warm, moist environment. Dangerous bacteria such as staphylococci, streptococci and enterococci quickly can cause life-threatening infections in such an environment.

    Removing Hand Flora

    • The best way to remove hand flora is through a surgical scrub. The surgical scrub method removes bacteria and dead skin from the hands and forearms. The technique can be timed with a clock or by the number of scrubs on each surface. Antibacterial soap is used to kill microbes on the skin. The hands must be kept above the elbows to drain dirty water away from the hands.

    Surgical Wash Technique

    • Wash the hands, wrists and forearms in warm, gently flowing water. Clean under each fingernail with a sterile file. With a sterile brush, scrub under each fingernail under the running water. Scrub the front, back and either side of each finger and both thumbs. Lather the palm sides and back of the hand with the scrub brush. Follow by scrubbing the wrist and finally the forearm. Rinse the hands from the fingertips to the forearms. Allow the water to drip as an assistant hands you a towel or bend over slightly to pick up a fresh sterile towel. Starting with the fingertips, dry by blotting with the sterile towel.

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