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Sterile Gowning and Closed Gloving in Perioperative Areas (2.3.15)

Sterile Gowning and Closed Gloving in Perioperative Areas (2.3.15) - Policies, Clinical, UW Health Clinical, General Care and Procedures, Procedures


Policy Title: Sterile Gowning and Closed Gloving in Perioperative Areas
Policy Number: 2.3.15
Category: UW Health
Type: Inpatient
Effective Date: November 15, 2016


A. To allow members of the surgical team to handle sterile instruments and equipment that is exposed to body
tissues during a surgical procedure, while simultaneously maintaining aseptic technique.
B. To avoid the potential of gown or glove contamination during the process of gloving.


A. To Put on a Sterile Gown
i. Complete the surgical hand antisepsis (scrub) per UWHC policy #13.08, Hand Hygiene.
ii. When possible, the donning of a sterile gown and gloves should be accomplished in a sterile area
away from the main instrument table.
iii. Pick up a sterile gown touching only the inside and step back from the sterile field where gown was
iv. Identify the top of the gown by finding the shoulder seams and neck band; hold the gown by the
shoulder seams while maintaining sterility of the outside of the gown.
v. Allow the gown to unfold from this position.
a. If any part of the gown inadvertently unfolds near an unsterile object (e.g., floor, fixture,
equipment or person) discard the gown and take another sterile gown, beginning again.
vi. Identify the armholes.
vii. Insert one hand into the armhole just far enough to grasp the rest of the gown with the hand
working within the armhole.
a. When working around sterile equipment, make sure that there is enough room to prevent
contamination by nonsterile equipment.
viii. Insert the other hand into the corresponding armhole.
ix. Keep arms shoulder-width away from torso (above the waist and below the shoulders) apart and
hold them in a fixed position while the non-sterile team member assists by pulling the gown over
the shoulders. Do not allow your hands to enter the cuff of the gown. Your hands must remain in
the sleeve.
a. The non-sterile team member avoids touching any part of the scrubbed areas of the arms
as the gown is being pulled on. The non-sterile team member shall secure the neckline
and the inside waist ties. These are unsterile areas of the gown.
B. To Put on Sterile Gloves Using the Closed Glove Technique
i. Hold the hand to be gloved palm up within the sleeve of the gown. On top, place the first glove
thumb down with the glove fingers toward the elbow.
a. Hands must stay within the sleeve until the gloves are pulled into place. Guard against
fingers inadvertently passing into or through the cuff.
ii. Work through the sleeve of the gown and grasp the lower part of the cuff of the glove with the hand
the glove is to be put on.
iii. Grasp the upper part of the glove using the other sleeve-covered hand, and pull it over the end of
the gown wristlet.
iv. Pull the glove completely on by pulling both glove cuff and gown sleeve at the same time with the
assisting sleeve-covered hand.
a. Assure that the knit cuff is completely covered by the sterile glove as this area is not
v. Repeat the above four steps for gloving the second hand by working with the new gloved first hand.
C. Securing the Sterile Back
i. Untie the sterile cord ties located at the waist near the right side of the gown using gloved hands.
ii. Secure the ties by handing the right tie to another team member and hold the left tie in your own
hand. Rotate your body slowly to prevent contamination. At this time, turn completely around and
retrieve the ties.
a. If a second sterile team member is not present, a sterile glove wrapper may be used to
ease this process by wrapping the end of the tie with the wrapper and handing it to
another person. Disposable gowns may contain a “card” with tie attached, which may be

Policy Title: Sterile Gowning and Closed Gloving in Perioperative Areas
Policy Number: 2.3.15

handed to a non-sterile person.
iii. Secure both ties at the waist level in front of your gown.
a. Should the waist level tie become contaminated, secure gown together with an atraumatic
instrument of appropriate weight.
D. For Removal of Gown and Gloves
i. Undo all gown ties and snaps.
a. The scrubbed person should untie the ties in front of the gown at the waist first. A non-
sterile team member, with clean hands will undo the back of the gown and the neck, to
avoid contaminating self with soiled gloves.
ii. Remove the gown without allowing your arms to touch anything except the inside of the gown
iii. Discard cloth gown in the linen hamper.
a. To prevent cross-contamination, used gowns should not be worn into other patient care
rooms, or outside of the operating room. Exceptions include x-ray and living related
transplant procedures.
iv. Remove gloves using the glove to glove and skin to skin technique.
a. Removing the gown and gloves in this order avoids exposure of the scrub person’s arms
and hand to the contaminated gown and gloves.
v. Perform hand hygiene per UWHC policy #13.08, Hand Hygiene.


Author: Directors, Surgical Services Department
Senior Management Sponsor: SVP, Patient Care Services and CNO
Reviewers: Perioperative Nursing Education Coordinator; Perioperative Nursing Education Specialist
Approval committees: Surgical Services Policy and Procedure Committee; UW Health Clinical Policy
UW Health Clinical Policy Committee Approval: October 17, 2016

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities.
This policy applies to facilities and programs operated by the University of Wisconsin Hospitals and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.


Peter Newcomer, MD
UW Health Chief Medical Officer

J. Scott McMurray, MD
Chair, UW Health Clinical Policy Committee


UWHC policy #13.08, Hand Hygiene

2015 AORN Standards, Recommended Practices and Guidelines.

Fuller, J. Surgical Technology Principles and Practice. Chapter 9 – Aseptic Technique. 5
Saunders Elsevier, 2010.

Association of Surgical Technologists (AST). Surgical Technology for the Surgical Technologist A Positive
Care Approach. Chapter 12 – Surgical Case Management. 3
edition. Delmar Cengage Learning, 2008.

Rothrock, J. Alexanders’ Care of the Patient in Surgery. Chapter 3 – Infection Prevention and Control in the
Perioperative Setting. 14
edition. Mosby, 2011.

Policy Title: Sterile Gowning and Closed Gloving in Perioperative Areas
Policy Number: 2.3.15


Version: Original
Next Revision Due: November 2019
Formerly Known as: Surgical Services departmental policy #2.25