The surgical scrub sink is being replaced with schmear.
The days of slathering povidone iodine or chlorhexidine solution over your hands and scrubbing your hands for 3-5 minutes with a soapy watery mess dripping from your elbows as you enter the procedure room or operating room no longer flies. Instead, you get to don “emollients” that stick like gooey glue to your hands and provide continuous “kill” to the bacteria throughout the surgical case. It seems there’s some industry-sponsored research that proves its improved bacterial kill rate. Just wipe in on your dry hands (yes, doctor, they must the dry), let the alcohol evaporate, and slide on those gloves! Total prep time – about 15 seconds. Fast, efficient, effective and relatively cheap.
What could be better?
But it was shocking to find this little orange dispenser next to the scrub sink (arrow) and my usual water-based soap dispenser removed:
Now, I look at our poor scrub sink. Lonely, cold, dull stainless steel. Who will love it when water no longer flows there? Instead, I now look down at my hand after squirting a bit of this slime there and wonder about its uncanny resemblance to… oh, never mind…
All in all, it’s been a paradigm shift in the way I prep for cases. Yes, it's faster. But there's never enough of this stuff to cover your hands and arms with one little squirt. And I ask myself, is it better for the patient? I'm not sure - it's just too early to tell. But one thing's for sure: the residue that remains bound to my hands at the end of each case is most disconcerting - bound for eternity to my dermis so that super-resistant organisms grow on my keyboard.
Why do I know this?
Because I no longer have any regular soap available to wash this stuff off.
Ref: Guidelines for Hand Hygiene in Health-care Settings (pdf): Recommendations of the Healthcare Infection Control Practices Advisory Committee and the ICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force, Morbidity and Mortality Weekly Report. October 25, 2002 / Vol. 51 / No. RR-16.