Sterility
Gowning and gloving in the operating room: sterile technique
Understand gowning and gloving as a controlled chain of contacts rather than a sequence to memorise.
The first time I had to don sterile gloves in the operating room, I felt unexpectedly awkward. I knew how to put on gloves, yet this time I had to control the package, hand position and contact between surfaces using a technique I had not yet made automatic.
That experience taught me that sterile gowning is not simply putting on a gown and gloves. It is understanding which surfaces may touch throughout the sequence.
Remembering the order is not enough
Surgical hand preparation, drying, gown and gloves: the sequence matters, but knowing it by heart does not guarantee correct technique. You can remember every step and still contaminate yourself if you lose awareness of what you are touching.
The method should be demonstrated, practised and assessed by an experienced professional, using the products and procedure approved by your organisation.
I focus on three questions:
- Where are my hands?
- Which part of the gown or glove am I holding?
- Which surface will be exposed during the next movement?
The what is the sequence. The how is continual control of contact. The why is maintaining the sterile barrier, not completing the movements as quickly as possible.
When your hands look for a shortcut
A fold catches, a glove does not advance correctly or your grip feels wrong. The instinct is to correct it quickly and continue. This is precisely when I slow down.
I used to think stopping would make me look incapable. Now I see that continuing without knowing which surfaces have touched means choosing the appearance of confidence over control.
Stopping means you have recognised the point at which the technique may no longer be reliable.
Sterile gloves do not make everything sterile
A sterile glove does not transform what it touches. It can lose its sterile status after inappropriate contact. The same is true of a gown.
Sterility does not belong permanently to an object. It depends on how the object was prepared, donned, handled and maintained. It exists in the chain of contacts that brought it to the present moment.
Doubt is not resolved by continuing
If you are uncertain about a contact, stop, describe what may have happened and follow local policy. You can say:
- “I think I touched that surface.”
- “I am not sure this glove is still sterile.”
- “I would prefer to repeat this step.”
Replacing a glove or repeating part of the process may feel like lost time. Continuing transfers the uncertainty to the next action, the equipment and potentially the sterile field.
Doffing also requires attention
At the end of the case, remove gown and gloves without transferring material from the external surfaces to your hands, clothing or environment. The logic changes: during donning, you protect sterile surfaces; during doffing, you contain used surfaces and avoid bringing contamination towards yourself.
Follow the locally approved sequence and complete hand hygiene as required.
Continue with The sterile field: the invisible boundary that protects the patient.