Water conservation in orthopaedic surgical scrubbing: a comparative analysis of water consumption in standard and modified surgical scrubbing techniques
Shahbaz, Aaisha Dinesh, Yash Dosanjh, Kamen S Muzammil, Sohail Imami, Fahad Shahbaz, Rohma Messwi, Mohamed Bose, Deepa
Shahbaz, Aaisha
Dinesh, Yash
Dosanjh, Kamen S
Muzammil, Sohail
Imami, Fahad
Shahbaz, Rohma
Messwi, Mohamed
Bose, Deepa
Affiliation
University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Doctors Hospital and Medical Center Lahore; Pakistan Air Force Hospitals; Combined Military Hospital Multan
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Publication date
2025-12-18
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Abstract
Background Surgical hand scrubbing plays a vital role in preventing surgical site infections. The current guidelines recommend a scrub that lasts between two and five minutes. This, however, poses a challenge where the traditional continuous flow scrub method consumes around 20 litres of water. With water scarcity quickly becoming a global issue, this highlights the importance of finding more efficient scrubbing techniques.
Objective A comparison of the duration of scrubbing and water consumed between the standard continuous flow technique and a modified tap on/off technique, to determine if significant water savings can be achieved without compromising scrub quality.
Methods This study was carried out in the trauma and orthopaedic department at Queen Elizabeth Hospital, Birmingham, UK. Thirty-four healthcare professionals participated by performing both standard and modified scrub techniques. To measure the amount of water, a 25-litre container along with a weighing method was used. Stopwatches were used to track the scrub duration and the time the tap was actively running.
Results The modified scrubbing technique led to reduced water use, as average staff members used 5.6 ± 1.78 litres (mean ± SD). In the standard technique, the median water use was 16.2 L (interquartile range (IQR) 6.15). The mean saving of 11.34 ± 5.57 litres (mean ± SD) was statistically significant (p < 0.0001). Scrub times were slightly longer with the modified technique, showing a mean increase of 14.96 ± 44.30 seconds (mean ± SD), but this did not reach a statistically significant difference.
Conclusion The modified scrubbing method delivers significant water savings without compromising the duration of the process. This makes it a practical and sustainable option, while also supporting the NHS's commitment to the environment.
Citation
Shahbaz A, Dinesh Y, Dosanjh KS, Muzammil S, Imami F, Shahbaz R, Messwi M, Bose D. Water Conservation in Orthopaedic Surgical Scrubbing: A Comparative Analysis of Water Consumption in Standard and Modified Surgical Scrubbing Techniques. Cureus. 2025 Dec 18;17(12):e99519. doi: 10.7759/cureus.99519.
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Article