Alcohol Hand Rub As Effective As Traditional Surgical Scrub and Better Tolerated

Abstract

Infectious Diseases| December 01 2002 Alcohol Hand Rub As Effective As Traditional Surgical Scrub and Better Tolerated AAP Grand Rounds (2002) 8 (6): 65–66. https://doi.org/10.1542/gr.8-6-65 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Alcohol Hand Rub As Effective As Traditional Surgical Scrub and Better Tolerated. AAP Grand Rounds December 2002; 8 (6): 65–66. https://doi.org/10.1542/gr.8-6-65 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: ethanol, hand, surgical scrub, acute aortic syndrome, anabolic steroids Source: Parienti JJ, Pascal T, Heller R, et al. Hand-rubbing with an aqueous alcoholic solution versus traditional hand-scrubbing and 30-day surgical site infection rates. JAMA. 2002;288:722–727. To compare the effectiveness of 2 hand-cleansing protocols in preventing surgical site infections (SSI), these investigators from a French multisite collaboration performed a randomized trial using a multiple-service crossover experimental design that alternated protocols monthly for 16 months. The study involved 4,387 patients on 6 surgical services (3 teaching, 3 nonteaching). All patients treated by the surgical services were eligible for study. Patients in contaminated or dirty procedures were excluded, as were patients who underwent a second operation within 15 days of the first. The experimental method involved hand-rubbing for a total of at least 5 minutes with 75% aqueous alcoholic solution (AAS) containing propanol-1, propanol-2, and mecetronium etilsulfate (Sterillium). Prior to the first procedure of the day or if their hands were visibly soiled, the AAS group scrubbed their hands for 1 minute with nonantiseptic soap. The control method involved at least 5 minutes of systematic hand-scrubbing with standard 4% providone iodine (Betadine) or 4% chlorhexidine (Hibiscrub). The primary outcome measure was the difference in the 30-day SSI rate between the hand-rubbing and hand-scrubbing groups. Surgical team compliance and tolerance to the agents were also evaluated. The nosocomial SSI rates were similar between the 2 protocols: 53 of 2,135 (2.48%) developed SSI in the hand-scrubbing protocol and 55 of 2,252 (2.44%) in the hand-rubbing protocol. Compliance with the duration of hand hygiene was poor in both protocols but was significantly better in the hand-rubbing group compared with the hand-scrubbing group (44% versus 28%; P=.008). Skin irritation and dryness were found to increase during hand-scrubbing months and decrease during hand-rubbing months. The authors concluded that hand-rubbing with AAS (preceded by a nonantiseptic hand wash) was equivalent to hand-scrubbing in preventing SSI and noted that hand-rubbing with AAS improved compliance with and tolerance to hand antisepsis protocols. Perhaps because of the awareness of increasing antimicrobial resistance and a perception by some that nosocomial infection rates are a proxy for quality, more attention is being paid to basic hygiene and other cost-effective methods, such as hand cleansing, to prevent the spread of communicable illness.1 Very poor compliance with proper hand hygiene remains a concern for all health care facilities.2 Even though the hand washing procedures in an office or clinic differ from those in the operating suite, the basic principles are those first advocated by Semmelweis,3 and this study offers practical insights for the busy pediatrician. The above study’s results would suggest that prudent clinicians should start each session with a 1-minute nonantiseptic hand wash before the first patient (to be repeated if the hands become soiled) followed by hand-rubbing with AAS between patients. As has been shown before, AAS—which is available in various brands as a gel, foam or liquid—is at least as effective as traditional hand washing, with less skin irritation and improved compliance.4... You do not currently have access to this content.