Allergic to scrubbing in?

[Treebeard]

This is probably a somewhat odd question, but I'm hoping someone can help...


I am an MS-2 and I just spent the week on a selective with the surgical oncology department. This was my first real experience in surgery (which I loved btw), and I got to scrub into a bunch of surgeries, >=1/day. Since Monday, I have had an increasingly itchy and prominent rash from the tops of my hands down across my arms to my elbows. I feel like this has to be related to either apgar or chlorhexidine.

Has anyone dealt with this or does anyone know what I can do about it? I really enjoyed surgery so I'm at least considering going into it, and either way I have to do 8 weeks of it in my third year.

Should I try to prophylacticly treat myself with hydrocortisone? I would prefer not to make a big deal of this on my M3 clerkship, but it's pretty painful and gross looking tbh

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[nimbus]

It’s common...try betadine scrub.

 

[Psai]

Leave Virginia out of this

 

[DoctwoB]

Agreed. Try betadine, see if that works better. If not it may just be sensitive skin reacting to the scrubbing itself. If thats the case then try to use dry scrub (Ava guard) if available.

 

[OrthoTraumaMD]

As others said, experiment with different types of scrub solutions. Also, make sure that you’re only scrubbing the “hard” parts of your hands (nails and palms) with the “bristles” portion. I used to have a terrible skin reaction cause I was scrubbing my arms like crazy with the plastic brush... scrub soft skin with the spongy part not the bristles.


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[Winged Scapula]

You can ask the OR sup if you can try other things as well - Johnson's baby wash, Cetaphil, etc. Ive seen used by others with the same problem, if the Betadine doesn't work.

 

[longhaul3]

Avagard every time if your hospital uses it. About 1/3 of the time with no scrubbing and no drying.

 

[Treebeard]

Avagard every time if your hospital uses it. About 1/3 of the time with no scrubbing and no drying.

My hospital has avagard but most of the scrub nurses really push for scrubbing with the sponges, at least for the first case of the day. Yes I realize this is not evidence based but not really the hill I wanna die on as an M2 potentially interested in surgery.

Thanks for the suggestions everyone. Maybe I'll reach out to some of the surgery residents I've met who may have had similar problems or know someone who has.

 

[nimbus]

FYI Avagard is chlorhexidine in alcohol.

3M™ Avagard™ (Chlorhexidine Gluconate 1% Solution and Ethyl Alcohol 61% w/w) Surgical and Healthcare Personnel Hand Antiseptic with Moisturizers | 3M United States

 

[longhaul3]

My hospital has avagard but most of the scrub nurses really push for scrubbing with the sponges, at least for the first case of the day. Yes I realize this is not evidence based but not really the hill I wanna die on as an M2 potentially interested in surgery.

Thanks for the suggestions everyone. Maybe I'll reach out to some of the surgery residents I've met who may have had similar problems or know someone who has.

Totally agree. Don't push it. Nothing you can do about arbitrary protocols.

 

[mistafab]

I highly suggest just trial and error at your hospital. They typically have loads of different stuff.

Personally, the avagard just rips up my hands. My little ritual w/ the scrub is nice anyway.

Find what works!