Chlorhexidine-coated surgical gloves influence the bacterial flora of hands over a period of 3 hours

Miranda Suchomel,Karen J Ousey,Markus Brillmann,Elisabeth Presterl,Ojan Assadian

doi:10.1186/s13756-018-0395-0

Miranda Suchomel, Karen J Ousey + Show 3 more

Open Access

https://doi.org/10.1186/s13756-018-0395-0

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Abstract

BackgroundThe risk of SSI increases in the presence of foreign materials and may be caused by organisms with low pathogenicity, such as skin flora derived from hands of surgical team members in the event of a glove breach. Previously, we were able to demonstrate that a novel antimicrobial surgical glove coated chlorhexidine-digluconate as the active ingredient on its inner surface was able to suppress surgeons’ hand flora during operative procedures by a magnitude of 1.7 log10 cfu/mL. Because of the clinical design of that study, we were not able to measure the full magnitude of the possible antibacterial suppression effect of antimicrobial gloves over a full 3 h period.MethodsThe experimental procedure followed the method for assessment of the 3-h effects of a surgical hand rub’s efficacy to reduce the release of hand flora as described in the European Norm EN 12791. Healthy volunteers tested either an antimicrobial surgical glove or non-antimicrobial surgical latex gloves in a standardized laboratory-based experiment over a wear time of 3 h.ResultsWearing antimicrobial surgical glove after a surgical hand rub with 60% (v/v) n-propanol resulted in the highest 3-h reduction factor of 2.67 log10. Non-antimicrobial surgical gloves demonstrated significantly lower (p ≤ 0.01) 3-h reduction factors at 1.96 log10 and 1.68 log10, respectively. Antibacterial surgical gloves are able to maintain a sustainable bacterial reduction on finger tips in a magnitude of almost 3 log10 (log10 2.67 cfu) over 3 h wear time.ConclusionIt was demonstrated that wear of an antibacterial surgical glove coated with chlorhexidine-digluconate is able to suppress resident hand flora significantly over a period of 3-h.

Highlights

The risk of SSI increases in the presence of foreign materials and may be caused by organisms with low pathogenicity, such as skin flora derived from hands of surgical team members in the event of a glove breach
There was no statistical significant difference in the log10 reduction factors between the two nonantimicrobial surgical gloves after a 3 h wear time. These results demonstrate that antibacterial surgical gloves were able to maintain a sustainable bacterial reduction on hands in a magnitude of almost 3 log10 over 3 h wear time
Bacteria may origin from a patient endogenously or may enter the sterile surgical site exogenously from the environment including the microbial flora of the surgical team, in case of glove breach [8, 9, 14, 18]

Summary

Introduction

The risk of SSI increases in the presence of foreign materials and may be caused by organisms with low pathogenicity, such as skin flora derived from hands of surgical team members in the event of a glove breach. We were able to demonstrate that a novel antimicrobial surgical glove coated chlorhexidine-digluconate as the active ingredient on its inner surface was able to suppress surgeons’ hand flora during operative procedures by a magnitude of 1.7 log cfu/mL. SSIs are associated with one third of post-operative related deaths [3], but more frequently they may cause cosmetically unacceptable scars, pain, prolonged duration of hospitalization, and emotional stress to patients, relatives, and care givers [4, 5]. Breach of glove integrity may cause bacterial migration from the surgeon’s hand to the surgical site [9]. The most important measure is preoperative surgical hand antisepsis using

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