In Vivo Comparison of Chlorine-Based Antiseptics versus Alcohol Antiseptic for Surgical Hand Antisepsis

Abstract

Despite being commonly used as effective preparation for surgical hand antisepsis, alcohol solutions have major drawbacks, such as drying effect, emergence of hand eczema, and other diseases. This study aimed to demonstrate the effectiveness of sodium hypochlorite (NaOCl) and hydrogen peroxide (H2O2) as antiseptic in comparison to single sodium hypochlorite and 70% ethanol. In 5-day tests, the effects of 3 antiseptics were established according to standard test methods. The antiseptics were applied to the hands of 82 volunteers, and samples of bacteria were collected on days 1 and 5, immediately after drying and 6 hours later after antiseptic application. Student’s t test and ANOVA were applied in a statistical study. The NaOCl with H2O2 composition demonstrated noninferiority to both sodium hypochlorite only and alcohol products and superiority to these antiseptics on day 5 (P<0.05 at a significance level of 5% for each comparative trial in this day) at equivalence margin of 20%. The effectiveness of the NaOCl plus H2O2 composition as an antiseptic was explained by the formation of singlet oxygen in the system. Together, these data suggest that NaOCl and H2O2 may be an effective hand antisepsis that avoids the drawbacks seen with alcohol solutions.

Efficacy of sodium hypochlorite in overcoming antimicrobial resistance and eradicating biofilms in clinical pathogens from pressure ulcers

“…The ideal antiseptic for managing an infected skin wound should combine therapeutic efficacy with tissue tolerability ( Kramer et al, 2018 ). Sodium hypochlorite (NaOCl) solutions are considered among the first choices for skin wound care due to their effectiveness against a wide range of planktonic and biofilm microorganisms, their role in promoting physiological tissue repair, and their anti-inflammatory actions ( Ciccia et al, 2018 ; Lineback et al, 2018 ; Myltykbayeva et al, 2020 ). The NaOCl has longed to be used as an antiseptic for patients on dialysis and to irrigate wounds and burns ( Bruch, 2006 ; Cruz et al, 2006 ; Alvarez et al, 2010 ).…”

Knowledge, attitudes, and practices on the usage of antiseptics prior to invasive medical procedures: Evidence from Sri Lankan Healthcare Professionals

“…10 Sri Lanka currently uses many different types of antiseptics in different concentrations according to availability and ease. 11 According to studies, the most widely used and clinically accepted antiseptic is chlorhexidine, [12][13][14] although not very commonly used in Sri Lanka. [14][15][16] Currently, there is a need for evidence-based survey studies in Sri Lanka on the commercial use of 70% alcohol, povidone-iodine, chlorhexidine, and other skin antiseptics, as well as the knowledge and attitude on the practical antiseptic usage in a healthcare setting.…”

“…10 Sri Lanka currently uses many different types of antiseptics in different concentrations according to availability and ease. 11 According to studies, the most widely used and clinically accepted antiseptic is chlorhexidine, 12 – 14 although not very commonly used in Sri Lanka. 14 – 16 …”