Antiseptic Effect of Conventional Povidone–Iodine Scrub, Chlorhexidine Scrub, and Waterless Hand Rub in a Surgical Room: A Randomized Controlled Trial

Abstract

OBJECTIVE Effective perioperative hand antisepsis is crucial for the safety of patients and medical staff in surgical rooms. The antimicrobial effectiveness of different antiseptic methods, including conventional hand scrubs and waterless hand rubs, has not been well evaluated. DESIGN, SETTING, AND PARTICIPANTS A randomized controlled trial was conducted to investigate the effectiveness of the 3 antiseptic methods among surgical staff of Taipei Medical University-Shuang Ho Hospital. For each method used, a group of 80 participants was enrolled. INTERVENTION Surgical hand cleansing with conventional 10% povidone-iodine scrub, conventional 4% chlorhexidine scrub, or waterless hand rub (1% chlorhexidine gluconate and 61% ethyl alcohol). RESULTS Colony-forming unit (CFU) counts were collected using the hand imprinting method before and after disinfection and after surgery. After surgical hand disinfection, the mean CFU counts of the conventional chlorhexidine (0.5±0.2, P<0.01) and waterless hand rub groups (1.4±0.7, P<0.05) were significantly lower than that of the conventional povidone group (4.3±1.3). No significant difference was observed in the mean CFU count among the groups after surgery. Similar results were obtained when preexisting differences before disinfection were considered in the analysis of covariance. Furthermore, multivariate regression indicated that the antiseptic method (P=.0036), but not other variables, predicted the mean CFU count. CONCLUSIONS Conventional chlorhexidine scrub and waterless hand rub were superior to a conventional povidone-iodine product in bacterial inhibition. We recommend using conventional chlorhexidine scrub as a standard method for perioperative hand antisepsis. Waterless hand rub may be used if the higher cost is affordable. Infect Control Hosp Epidemiol 2017;38:417-422.

Surgical Site Infection: Are Surveillance and Risk Prevention Measures Institutionally Applied?

“…Um estudo experimental randomizado comparou três diferentes agentes antimicrobianos para degermação das mãos (13) . Os resultados indicaram que a degermação realizada com escova, água e 4% de clorexidina ou lavagem das mãos sem água em solução alcoólica com gluconato do clorexidine, reduziram mais a quantidade microbial das mãos quando comparados à escovação com água contendo 10% de iodo com polivinilpirrolidona (13) .…”

“…Os resultados indicaram que a degermação realizada com escova, água e 4% de clorexidina ou lavagem das mãos sem água em solução alcoólica com gluconato do clorexidine, reduziram mais a quantidade microbial das mãos quando comparados à escovação com água contendo 10% de iodo com polivinilpirrolidona (13) . A prática tradicional com o uso de escovas e água poderia ser repensada, uma vez que lavar as mãos com solução alcoólica com efeito residual reduziu mais a quantidade microbial das mãos quando comparada à escovação com 10% de iodo polivinilpirrolidona (13) . O CDC e a OMS corroboram esta discussão, uma vez que a lavagem das mãos com antissépticos é recomendada pelas agências de saúde (4,7) .…”

Surgical hand antisepsis: experimental study

“…In a study done in Taiwan by Tsai et al [ 19 ], in a clinical trial with 236 patients, povidone iodine was compared to soap with chlorhexidine and ethyl alcohol with chlorhexidine gluconate. In this study they found that the amount of CFUs growth with soap and chlorhexidine and chlorhexidine/alcohol was more efficacious than povidone iodine.…”

“…Today, there is a large amount of antiseptics with various active ingredients whose properties have not been analyzed in our setting that could be very useful for hand washing and thus reduce the transmission rate of infections [ 18 19 20 ].…”

Effectiveness of Surgical hand Washing with Chlorhexidine, Providone iodine and Alcohol on Reducing the Microorganisms on the Hands: A Systematic Review

“…The most common cause is the hands of the surgical team (Abdollahi, Tabrizi, Jodati, Safaie, & Moradi-joo, 2017). Perioperative hand hygiene is one of the most critical factors affecting the risk of surgical site infection (SSI) as well as the safety of the medical staff (Tsai, Lin, Huang, Loh, & Wen, 2016). The hands of the surgical team are known to be the most important source of micro-organisms from the skin during surgery (Ghorbani, Shahrokhi, Soltani, Molapour, & Shafikhani, 2012).…”