Written and maintained by CASRAI Editorial Board
Last updated
General product and regulatory information, not medical advice and not a technique guide. Facility protocols and the manufacturer’s labeling govern actual practice.
Short answer
Hand scrub surgery, also called surgical hand scrubbing, is the CDC’s “surgical hand antisepsis”: an antiseptic handwash or antiseptic hand rub done before an operation to eliminate transient and reduce resident hand flora. The CDC guideline allows either an antimicrobial soap or an alcohol-based hand rub with persistent activity, and points to the manufacturer’s instructions for how each product is used.
What a surgical hand scrub is
The CDC/HICPAC Guideline for Hand Hygiene in Health-Care Settings (MMWR 2002;51(RR-16)) defines surgical hand antisepsis as an “antiseptic handwash or antiseptic hand rub performed preoperatively by surgical personnel to eliminate transient and reduce resident hand flora.” It is done before donning sterile gloves. The guideline dates from 2002, so a facility’s current policy may add to it.
Three different things are often blurred under the phrase “hand scrub”, and keeping them apart is the quickest way to read a product label or a policy correctly:
- The act: surgical hand antisepsis, as defined above.
- The product: in the United States, “surgical hand scrub drug products” is a named category in the FDA’s over-the-counter antiseptic regulation, 21 CFR 310.545.
- The timing authority: the manufacturer’s labeling, not a single number in a textbook.
This page does not repeat the brush-versus-sponge discussion; see Surgical Scrub Brush: What CDC Guidance Says. For the underlying product class, see What Is an Antiseptic?
Scrub with antimicrobial soap or alcohol-based rub (CDC)
The CDC guideline recommends surgical hand antisepsis “using either an antimicrobial soap or an alcohol-based hand rub with persistent activity” before donning sterile gloves (category IB). The two routes differ in what the guideline says about them:
| Question | Antimicrobial soap | Alcohol-based rub with persistent activity |
|---|---|---|
| Where the use instructions live | The manufacturer’s labeling | The manufacturer’s labeling |
| What the product must have | Antimicrobial formulation | Persistent activity |
Who sets the use instructions: the label, not the textbook
The CDC guideline defers to the manufacturer’s instructions rather than giving one figure for every product. For a lab, clinic or supply team the practical consequence is that the use instructions and any persistence claim belong to the product in use and to the facility’s written protocol, and this page deliberately gives no times or technique.
The FDA category behind the product
21 CFR 310.545(a)(27)(viii) lists “Surgical hand scrub drug products” as “approved as of December 20, 2018”, and paragraph (d)(42) sets December 20, 2018 as the compliance date for products under paragraphs (a)(27)(vi) through (x). The rule names the active ingredients permitted in that category; this page lists none as a recommendation, because the ingredient list is a regulatory status, not a purchasing guide. For ingredient-specific label reading, see Povidone-Iodine Antiseptic Solution: Label Guide and, for a different antiseptic use, Chlorhexidine (CHG) Bathing Protocol.
Checklist for labs, clinics and supply staff
This checklist separates what the CDC guideline specifies from what it leaves to the label or the facility. Each row traces to the guideline or the CFR section cited above.
| Item | What the source says | Where the answer lives |
|---|---|---|
| Product route | Antimicrobial soap, or alcohol-based rub with persistent activity (IB) | CDC guideline |
| Use instructions for the product | Follow the manufacturer’s instructions | Product label |
| Regulatory category | “Surgical hand scrub drug products” under 21 CFR 310.545 | FDA regulation and product labeling |
Documents worth having on file for any product in use: its labeling, the manufacturer’s use instructions, any persistence statement, and the facility protocol that adopts them. For the wider surgical-safety setting, see Universal Protocol and the Surgical Safety Checklist; for what follows at the sterile field, see How to Put On Sterile Gloves and What Is a Sterile Drape?
Common misunderstandings
“The instructions are the same for every product.”
For soap and for alcohol-based rubs the guideline refers to the manufacturer. The instructions come from the product label.
“Any hand sanitizer qualifies.”
The guideline specifies an alcohol-based hand rub with persistent activity, and the FDA regulation treats surgical hand scrub drug products as a defined category. A general-purpose product is not automatically either.
FAQ
What is surgical hand scrubbing?
It is the CDC’s “surgical hand antisepsis”: a preoperative antiseptic handwash or hand rub that eliminates transient and reduces resident hand flora.
Who decides how a surgical hand scrub product is used?
The CDC guideline refers to the manufacturer’s instructions, together with the facility’s written protocol. This page gives no times or technique.
Is a surgical hand scrub product a regulated category?
Yes. In the United States, “Surgical hand scrub drug products” is a named category in 21 CFR 310.545(a)(27)(viii).
Sources
- CDC/HICPAC, Guideline for Hand Hygiene in Health-Care Settings, MMWR 2002;51(RR-16): https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm (checked 2026-11-01).
- 21 CFR 310.545, Drug products containing certain active ingredients offered over-the-counter for certain uses: https://www.law.cornell.edu/cfr/text/21/310.545 (checked 2026-11-01).
