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Surgical Hand Antisepsis With Alcohol-Based Hand Rub Comparison of Effectiveness After 1.5 and 3 Minutes of Application

Published online by Cambridge University Press:  02 January 2015

Walter P. Weber ,
Stefan Reck ,
Uschi Neff ,
Ramon Saccilotto ,
Marc Dangel ,
Manfred L. Rotter ,
Reno Frei ,
Daniel Oertli ,
Walter R. Marti  and
Andreas F. Widmer
Walter P. Weber
Affiliation:
Department of Surgery, University Hospital Basel, Basel, Switzerland
Stefan Reck
Affiliation:
Department of Surgery, University Hospital Basel, Basel, Switzerland
Uschi Neff
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Ramon Saccilotto
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Marc Dangel
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Manfred L. Rotter
Affiliation:
Department of Hygiene and Medical Microbiology, Medical University of Vienna, Vienna, Austria
Reno Frei
Affiliation:
Microbiology Laboratory, University Hospital Basel, Basel, Switzerland
Daniel Oertli
Affiliation:
Department of Surgery, University Hospital Basel, Basel, Switzerland
Walter R. Marti
Affiliation:
Department of Surgery, University Hospital Basel, Basel, Switzerland
Andreas F. Widmer*
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
*
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland (awidmer@uhbs.ch)
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Abstract

Objective.

Research has shown 1.5 minutes of surgical hand antisepsis with alcohol-based hand rub to be at least as effective under experimental conditions as the 3-minute reference disinfection recommended by European Norm 12791. The aim of the present study was to validate the effectiveness of 1.5 minutes of surgical hand antisepsis in a clinical setting by comparing the effectiveness of 1.5- and 3-minute applications of alcohol-based hand rub (45% vol/vol 2-propanol, 30% vol/vol 1-propanol, and 0.2% mecetronium ethylsulphate).

Design.

Prospective crossover trial in which each surgeon served as his or her own control, with individual randomization to the 1.5-or the 3-minute group during the first part of the trial.

Setting.

Basel University Hospital, Switzerland.

Participants.

Thirty-two surgeons with different levels of postdoctoral training.

Methods.

We measured the bactericidal effectiveness of 1.5 minutes and 3 minutes of surgical hand antisepsis with alcohol-based hand rub by assessing the mean (± SD) log10 number of colony-forming units before the application of hand rub (baseline), after the application of hand rub (immediate effect), and after surgery (sustained effect) so as to follow European Norm 12791 as closely as possible.

Results.

The immediate mean (± SD) log10 reduction in colony-forming units (cfu) was 2.66 ±1.13 log10 cfu for the 1.5-minute group and 3.01 ±1.06 log10 cfu for the 3-minute group (P = .204). Similarly, there was no statistically significant difference between the 2 groups with respect to the sustained effect; the mean ( ± SD) log10 increase in bacterial density during surgery was 1.08 ± 1.13 log10 cfu for the 1.5-minute group and 0.95 ± 1.27 log10 cfu for the 3-minute group (P = .708). No adverse effects were recorded.

Conclusion.

In this clinical trial, surgical hand antisepsis with alcohol-based hand rub resulted in a similar bacterial reduction, regardless of whether it was applied for 3 or 1.5 minutes, which confirms experimental data generated with healthy volunteers.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 5 , May 2009 , pp. 420 - 426
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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