The effects of ‘in-use’ surgical handwashing on the pre- and postoperative fingertip flora during cardiothoracic and orthopaedic surgery

Christensen, Joseph; Andersen, Bjørg Marit; Thomassen, Stephan; Johansen, Oddmund; Lie, Mons

doi:10.1016/0195-6701(95)90263-5

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…Also, an incidence of 36% of surgeons’ fingertips was contaminated by Gram-positive bacteria. 131 High prevalence of skin recolonization at the end of surgery was highlighted. 129…”

Section: Discussionmentioning

confidence: 99%

Latitude of the study place and age of the patient are associated with incidence of mediastinitis and microbiology in open-heart surgery: a systematic review and meta-analysis

Abdelnoor

Vengen

Johansen

et al. 2016

CLEP

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ObjectiveWe aimed to summarize the pooled frequency of mediastinitis following open-heart surgery caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), and Gram-negative bacteria.DesignThis study was a systematic review and a meta-analysis of prospective and retrospective cohort studies.Materials and methodsWe searched the literature, and a total of 97 cohort studies were identified. Random-effect model was used to synthesize the results. Heterogeneity between studies was examined by subgroup and meta-regression analyses, considering study and patient-level variables. Small-study effect was evaluated.ResultsSubstantial heterogeneity was present. The estimated incidence of mediastinitis evaluated from 97 studies was 1.58% (95% confidence intervals [CI] 1.42, 1.75) and that of Gram-positive bacteria, Gram-negative bacteria, and MRSA bacteria evaluated from 63 studies was 0.90% (95% CI 0.81, 1.21), 0.24% (95% CI 0.18, 0.32), and 0.08% (95% CI 0.05, 0.12), respectively. A meta-regression pinpointed negative association between the frequency of mediastinitis and latitude of study place and positive association between the frequency of mediastinitis and the age of the patient at operation. Multivariate meta-regression showed that prospective cohort design and age of the patients and latitude of study place together or in combination accounted for 17% of heterogeneity for end point frequency of mediastinitis, 16.3% for Gram-positive bacteria, 14.7% for Gram-negative bacteria, and 23.3% for MRSA bacteria.ConclusionEvidence from this study suggests the importance of latitude of study place and advanced age as risk factors of mediastinitis. Latitude is a marker of thermally regulated bacterial virulence and other local surgical practice. There is concern of increasing risk of mediastinitis and of MRSA in elderly patients undergoing sternotomy.

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“…Also, an incidence of 36% of surgeons’ fingertips was contaminated by Gram-positive bacteria. 131 High prevalence of skin recolonization at the end of surgery was highlighted. 129…”

Section: Discussionmentioning

confidence: 99%

Latitude of the study place and age of the patient are associated with incidence of mediastinitis and microbiology in open-heart surgery: a systematic review and meta-analysis

Abdelnoor

Vengen

Johansen

et al. 2016

CLEP

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“…As the number of micro‐organisms is greater on unwashed than washed hands 21 , 22 there is a risk of infection as glove leaks develop with use 1 , 4 , 5 . Antiseptic handwashing prior to donning gloves markedly reduces bacteria on hands and may have a residual effect even after 2–3 hours 22 . It controlled an outbreak of Staphylococcus epidermidis in a cardiac surgical unit 23 .…”

Section: Discussionmentioning

confidence: 99%

The use of gloves in Australian dermatological practice

Ong

Commens

1999

Aust J Dermatology

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Dermatologists use gloves as a major tool in universal precautions to prevent transmission of infections particularly human immunodeficiency virus (HIV) and hepatitis. We need to know how much protection is conferred by gloves and what problems are associated with glove use. This paper looks at these issues and reports the results of a survey on glove use by Australian dermatologists. The survey found a lack of awareness regarding gloves as a protective measure, suggesting the need to improve knowledge in this area so that realistic precautions can be adopted. Dermatologists have a high rate of glove use and reactions to gloves were noted by 13% of respondents. The authors recommend the use of non-powdered, low-allergen latex gloves. Handwashing prior to using non-powdered latex gloves needs further investigation. Handwashing after wearing latex gloves may decrease sensitization risk.

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Section: Sterile Gloves: Surgical Glovesmentioning

confidence: 99%

“…In one study, 6% of the surgical team had bacteria on fingertips immediately after surgical handwash and sterile gloving, and at the end of the operation, 6.6% of the gloved fingertips and 51% of fingertips without gloves were contaminated with bacteria [27]. In all, 96.6% of surgeons had sterile glove fingertips at the end of the operation [27]. S. aureus and 17 different gram-negative bacteria among common skin bacteria were detected, mostly before (after surgical hand disinfection) but also after the end of operation [27].…”

Section: Sterile Gloves: Surgical Glovesmentioning

confidence: 99%

Operation Department: Infection Control

Andersen

2019

Prevention and Control of Infections in Hospitals

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Infection control in the operation department is the result of many single factors and routines, based on experience, documentation and expert panels through more than a hundred years. Many factors and routines in surgery are evidencebased, but most of them are still lacking evidence and can probably never be investigated because of ethical problems. Consequently, consensus and guidance are used to a great extent. Surgery opens into sterile tissues for hours, where there is massive tissue damage by knife, diathermy, clogging of vessels, pressure against and drying of tissues, decreased blood supply, impaired phagocytosis and impaired infection defence. Microbes deposited in this devitalized tissues may find a good basis for growth and proliferation if there is lack of infection control and sterility. For patients with ongoing infections and who need surgery, special routines are made to prevent the spread of infections in the operation department. This chapter is a practical description of many important preventive procedures that may protect the surgical patient against surgical site infection (SSI).

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The effects of ‘in-use’ surgical handwashing on the pre- and postoperative fingertip flora during cardiothoracic and orthopaedic surgery

Cited by 7 publications

References 26 publications

Latitude of the study place and age of the patient are associated with incidence of mediastinitis and microbiology in open-heart surgery: a systematic review and meta-analysis

Latitude of the study place and age of the patient are associated with incidence of mediastinitis and microbiology in open-heart surgery: a systematic review and meta-analysis

The use of gloves in Australian dermatological practice

Operation Department: Infection Control

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