Ann Surg Treat Res.  2018 Jul;95(1):1-6. 10.4174/astr.2018.95.1.1.

Surgical hand antisepsis: experimental study

• Izaguirre
• Govela A
• Delgado I
• Troncoso C
• Parra M
• Viaña EA

• KMID: 2414446
• DOI: http://doi.org/10.4174/astr.2018.95.1.1

Abstract

PURPOSE
Nosocomial infections account for one of the most serious complications in hospitalized patients around the world. Surgical site infections have significant economic implications, and surgical antisepsis plays an important role in such processes.
METHODS
With prior approval by the Institutional Review Board and informed consent, 10 volunteers were randomly assigned to 3 protocols on hand antisepsis: protocol A (chloroxylenol 3%), protocol B (benzalkonium chloride at 1%), and protocol C (ethyl alcohol 61%, 1% chlorhexidine gluconate). Smears from both hands were cultured after each hand pro tocol (t0) and at the end of suturing (t1). Colony forming units were counted (CFUs on blood agar dishes) with digital counting software (Open CFU). Friedman test was used to compare the mean values among the groups, and a Bonferroni correction was made to determine the dissimilar group, with a P = 0.015.
RESULTS
At t0 for protocol A the CFU count was 82.8 ± 1.3; protocol B was 9.7 ± 30; protocol C was 0.1 ± 0.3 (P < 0.001). At t1 for protocol A the CFU was 80.7 ± 89.4; protocol B was 7.5 ± 32; protocol C was 0.0 ± 0.0 (P < 0.001). No adverse events were present among the subjects.
CONCLUSION
Ethyl alcohol at 61% with 1% chlorhexidine gluconate showed higher efficacy than the traditional washing antiseptics.

Keyword

Infection control; Antisepsis

MeSH Terms

Agar
Anti-Infective Agents, Local
Antisepsis*
Chlorhexidine
Cross Infection
Ethanol
Ethics Committees, Research
Hand*
Humans
Infection Control
Informed Consent
Stem Cells
Surgical Wound Infection
Volunteers
Agar
Anti-Infective Agents, Local
Chlorhexidine
Ethanol

Figure

• 

  Fig. 1 Colony forming units on blood agar dishes. A, chloroxy lenol; B, benzalkonium chloride; C, alcohol 61% y chlorhexidine at 1%. D, right, I, left. Before the practice (t0) after the practice (t1).

• 

  Fig. 2 Bar graph comparing the amount of CFUs with 3 antiseptics: A, chloroxylenol; B, benzalkonium chloride; C, alcohol 61% y chlorhexidine at 1%. Note that in groups B and C there was a reduction in CFUs, however almost null growth was observed in group C. Values are presented as mean ± 2 standard deviation. *Wilcoxon signed test A vs. C t1, P < 0.001. †Wilcoxon signed test B vs. C t1, P = 0.027. t0, time zero; t1, time after practice.

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