Optimum duration of surgical scrub-time

O’Shaughnessy, Michelle M.; O’Malley, Vincent; Corbett, Gareth; Given, H. F.

doi:10.1002/bjs.1800780617

Cited by 68 publications

(32 citation statements)

References 5 publications

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“…2 Once the hair has been removed from the area, the surgical site is scrubbed according to one of the many recommended protocols in human and veterinary literature. [5][6][7][9][10][11][12][13][14][15] Most post-operative infections are caused by a continuing source of endogenous microorganisms on the patient's skin. 16,17 Pre-operative skin preparations using a topical antiseptic on the surgical site is recognised as the most important measure in minimizing potential infection by reducing endogenous skin microflora.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of three antiseptics as surgical skin preparations in dogs

Boucher

Henton²,

Becker

et al. 2018

Veterinary Surgery

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Objective To compare the antimicrobial efficacy of a 2% chlorhexidine gluconate and 70% ethanol solution (CG+A) with that of F10 Skin Prep Solution (F10) and electrochemically activated water (EAW) when used as a surgical preparation in canine patients. Study design Prospective randomized clinical study. Sample population One hundred sixteen dogs presented for ovariohysterectomy. Methods Dogs were randomly divided into 1 of the 3 antiseptic groups (CG+A, F10, EAW). Skin samples with replicating organism detection and counting plates were taken at 4 different perioperative sites and time intervals (postskin preparation, postskin antisepsis, 2 hours after the second sample, and at the end of surgery) during ovariohysterectomies performed by students. The colony forming unit (CFU) counts from each sample were quantified according to the level of bacterial contamination. Zero CFU was defined as no contamination, 1‐12 CFU was defined as low contamination, and greater than 12 CFU was defined as high contamination. The 3 antiseptics were compared with respect to the level of contamination. Results There was no difference in the level of colonization between the antiseptics at the first sampling time (P = .454). However, the level of contamination for CG+A was lower compared with F10 and EAW at the second, third, and fourth sampling times (P = .001, P = .01, P = .02, respectively). Conclusion CG+A was more effective at achieving a zero CFU count and low levels of contamination compared with F10 and EAW for surgical preparation in dogs undergoing ovariohysterectomy. Clinical significance This study does not provide evidence to support the use of F10 and EAW instead of CG+A for the surgical skin preparation of dogs undergoing ovariohysterectomy.

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Section: Introductionmentioning

confidence: 99%

Comparative efficacy of three antiseptics as surgical skin preparations in dogs

Boucher

Henton²,

Becker

et al. 2018

Veterinary Surgery

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“…In the absence of data to quantify our water use accurately, we measured the amount of water over a standard 3-min period as advised for traditional scrubbing in the literature. 4,5 In the absence of published data on water use in hospital operating departments, we cannot compare our findings to other institutions but hope to highlight the environmental cost of water use in the operating department. To our knowledge, our study is the first to do so.…”

mentioning

confidence: 99%

Clean and Green: Saving Water in the Operating Theatre

Jehle

Jarrett

Matthews

2008

annals

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Ann R Coll Surg Engl 2008; 90: 22-24 22Tw enty years before Louis Pasteur developed the germ theory, Ignaz Semmelweis in Vienna established the practice of washing hands in a chloride solution to prevent puerperal fever. 1 Joseph Lister, who is widely credited for introducing asepsis into surgery, subsequently started sterilising bandages and surgical instruments with steam and used carbolic acid to clean wounds with great success. Today, surgical hand disinfection remains an important part of modern surgical practice.Traditionally, surgical hand disinfection (scrubbing) comprises washing with antimicrobial soap containing water, detergent and an antiseptic agent such as chlorhexidine, iodine, alcohol or a quaternary ammonium compound. The minimum recommended time to ensure disinfection varies between 2-6 min depending on the product used. Alternative alcohol-based hand rub disinfectants can provide superior disinfection 2 when compared to traditional techniques, thus saving a significant amount of water at a time when this resource is in high demand.The objectives of this study were to: (i) quantify water usage of operating theatre staff during surgical hand disinfection and thereby estimate potential water savings in using alternative means of hand disinfection; and (ii) investigate the cost involved in adopting a new hand disinfection technique in our hospital. Materials and MethodsThe number of operations and operating lists over a 1-year period, including the number of scrubbed staff members involved in every procedure, was determined from a prospectively collected theatre database. In order to determine the amount of water and disinfectants used during a scrubbing episode, we undertook a small observational study of 30 scrub episodes in our operating department, collecting data on the time period that taps were running and the number of squirts of soap or alcohol rub used by theatre staff. The volumes of the two traditional antimicrobial soaps used, chlorhexidine gluconate solution 20% (Hibiscrub™, Regent Medical Ltd, Irlam, UK) and Povidone-iodine 7.5% in aqueous solution (Videne ® , Adams Healthcare, Leeds, UK), was measured by then dispensing the soaps into a 50-ml syringe from their standard dispensers. The amount of alcohol rub (Sterillium ® , Bode Chemie, Hamburg, Germany) used to disinfect hands was measured from standard dispensers, again by using a 50-ml syringe. In addition, the There is a growing trend to use alcohol-based hand disinfectants in clinical practice. In addition to their antibacterial efficacy, these disinfectants offer an alternative to traditional surgical hand disinfection agents that can save water in the operating theatre.

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“…This study recommended a 4-minute scrub for the surgical team's first procedure and a 2-minute scrub for subsequent procedures. 541 Bacterial counts on hands after 2-minute and 3-minute scrubs with 4% chlorhexidine gluconate were compared. 542 A statistically significant difference in mean CFU counts was found between groups with the higher mean log reduction in the 2-minute group.…”

Section: Required Time For the Proceduresmentioning

confidence: 99%

“…284,511,512 In other studies, scrubbing for 2 or 3 minutes reduced bacterial counts to acceptable levels. 378,380,460,529,541,542 Surgical hand antisepsis using an alcohol-based handrub required 3 minutes, following the reference method outlined in EN 12791. Very recently, even 90 seconds of rub have been shown to be equivalent to a 3-minute rub with a product containing a mixture of iso-and n-propanol and mecetronium etilsulfate 557 when tested with healthy volunteers in an in vivo experiment.…”

Section: Required Time For the Proceduresmentioning

confidence: 99%