Surgical Hand Washing Research Articles

Evaluating the Personal Protective Equipment and Surgical Hand-Washing Knowledge Levels of Nursing Students in the Preoperative Period

Evaluating the Personal Protective Equipment and Surgical Hand-Washing Knowledge Levels of Nursing Students in the Preoperative Period

"Water or not water: That is the question." Analysis of costs and consumption of the operating theaters in a greener perspective.

To compare the amounts of water and plastic used in surgical hand washing with medicated soaps and with alcohol-based products and to compare costs and consumption in a year, based on scheduled surgical activity. This retrospective study was carried out at Udine's Gynecology Operating Block from October to November 2022. We estimated the average amount of water with a graduated cylinder and the total cost of water usage based on euros/m3 indicated by the supplier; for each antiseptic agent we collected the data relevant to wash time, amount of water and product used per scrub, number of handscrubs made with every 500 mL bottle and cost of a single bottle. We put data into two hypothetical contexts, namely WHO guidelines and manufacturers' recommendations. Data were subjected to statistical analysis. The daily amount of water using povidone-iodine, chlorhexidine-gluconate and alcohol-based antiseptic agents was 187.6, 140.7 and 0 L/day (P value = 0.001), respectively; A total of 69 000 L/year of water would be saved if alcohol-based products were routinely used. A single unit of an alcohol-based product allows three times as many handscrubs as any other product (P value = 0.001) with consequent reduction in plastic packaging. Despite the cost saving being negligible, choosing alcohol-based handrub over medicated soap handrub - on equal antiseptic efficacy grounds - could lead to a significant saving of water and plastic, thus making our operating theaters more environmentally friendly.

Bacterial contamination in the operating room at Hue Central Hospital, 2nd branch

ABSTRACT Objectives: This study aims to evaluate the microbial contamination level and identify bacterial colonization of the operating room in the hospital. Methods: Three sampling procedures were used in this study, which includes swabbing, air sampler and contact agar plate. Collected samples from 8 ORs were transported and microbiologically processed using standard procedures. Bacteria were identified by morphological, biochemical tests and Vitek 2 Compact system. Microbiological criteria were based on recommendation of the Ministry of Health. Results: The incidence of positive cultures was 285/600 (47.50%). The most common isolates were Gram - positive bacteria (98.25%) while low rate of Gram - negative bacteria (1.75%) was surveyed with Pseudomonas sp. (0.7%) and Enterobacter cloacae (1.05%). The water used for surgical hand washing illustrated the existence of Staphylococcus blanc (60%) and each of Pseudomonas sp. and Enterobacter cloacae (20%). Air contamination were observed with Bacillus sp. (46.90%) and Staphylococcus blanc (53.10%). Environmental surfaces were detected 7 species, of which 4 threaten strains including Staphylococcus aureus accounted for 5.55%, followed by Streptococcus β - hemolytic (0.79%), Pseudomonas sp. (0.79%) and Enterobacter cloacae (1.59%). Surgeons’s hand samples were isolated with Bacillus sp. (14.55%) and Staphylococcus blanc (1.81%). The rate samples of ORs surfaces reaching level A and B accounted for 91.49% and 8.51% while none of the samples approach level C and level D. The rate of qualified samples in terms of air, water for surgical hand washing, surfaces of medical instruments and surgeons’ hands was remarkably high with 87.59%, 98.44%, 95.24% and 100%, respectively. Conclusion: Our study showed various bacteria isolated, of which pathogenic species occupied very low percentage. Especially, the rate of samples in the study that meet microbiological standards was remarkably high according to Ministry of Health recommendation.

Retracted: Comparison of Improved Surgical Eight-Step Handwashing Combined with ATP Fluorescence in Detecting the Infection Rate at the Site of Seven-Step Surgical Handwashing and 30-Day Orthopaedic Surgery: A Randomized Study.

[This retracts the article DOI: 10.1155/2022/3123565.].

Effect of On -Job Training Program on Nurses' Compliance and Satisfaction with Infection Control Measures at Obstetric Operating Room

Background: The primary area of concentration in the operating room for obstetrics is infection control. Nurses engaged practise infection control diminish the probability of pathogens getting to women. Aim of the study: study intention was meet out in what way an on-the-job training program light speed nurses' compliance and satisfaction with infection control procedures inside obstetric operating apartment. Design: To conduct the study, a quasi-experimental approach was taken Setting: The study was done in the obstetrics operating room of the Benha. Sample: will involve all (70) nurses who work in the obstetric operating room. Tools: Structured interview questions, an observation checklist, and nurses' satisfaction. Results: shows that there was a highly statistically significant improvement in wearing protective clothing, surgical hand washing, gloving, gowning, masking, handling sharp instruments, cleaning, and sterilization in post-on-the-job training program compared to 28.6 percent, 31.4 percent, 54.3 percent, 28.6 percent, 40.0 percent, 31.4 percent. Conclusion: Compared to before the on-the-job training program, there was a highly statistically significant improvement in nurses' overall knowledge, compliance, and satisfaction. Recommendations: Continued on-the-job training programs should be used to update nurses' knowledge and compliance.

SG-APSIC1107: Effectiveness of interventions increasing surgical hand hygiene compliance at Hung Vuong Hospital

Objectives: Surgical handwashing is one of the most important measures to prevent surgical site infection (SSI). We evaluated the effectiveness of the intervention program on surgical handwashing compliance of healthcare workers (HCWs) at Hung Vuong Hospital. Methods: This research was conducted from July 2019 to November 2019 in 3 phases. In the first phase, we determined the surgical handwashing compliance rate before the intervention. In the second phase, we implemented an intervention bundle as follows. We provided reminders of compliance in the form of video screen and automatic timers at surgical handwashing sinks. We provided links and QR codes for online access and live streaming of instructional videos on implementation of the hospital’s surgical hand sanitation procedures in the surgical handwashing area. We conducted direct monitoring to remind and guide HCWs to follow the procedures in combination with camera surveillance to accurately reflect compliance. Finally, we provided feedback in multiple steps: feedback to individual, feedback to head of department or department heads, cited names in briefings and sent names to the general planning department to suspend surgery privileges. In the third phase, we re-evaluated the surgical handwashing compliance rate after the intervention. Results: The total number of surgical handwashing checklists observed before and after the intervention was 787. The surgical handwashing compliance rate improved significantly from 48.8% to 71.8% (PR, 2.7; 95% CI, 1.98–3.57; P < .01). The compliance rate in camera monitoring also increased from 22.1% to 57.9% (PR, 4.8; KTC 95%, 3.14–7.47; P < .01). The compliances rates of both surgeons and scrub nurses improved significantly after the intervention (P < .01). Conducting the new surgical handwashing procedure increased from 90.2% to 99.5% after this intervention. Conclusions: This intervention program improved surgical handwashing compliance of HCWs.

Sustainability in interventional radiology: are we doing enough to save the environment?

BackgroundHealthcare waste contributes substantially to the world’s carbon footprint. Our aims are to review the current knowledge of Interventional Radiology (IR) waste generation and ways of reducing waste in practice, to quantify the environmental and financial impact of waste generated and address green initiatives to improve IR waste management.MethodsA systematic literature search was conducted in July 2022 using the Medline and Embase literature databases. The scope of the search included the field of IR as well as operating theatre literature, where relevant to IR practice.ResultsOne-hundred articles were reviewed and 68 studies met the inclusion criteria. Greening initiatives include reducing, reusing and recycling waste, as well as strict waste segregation. Interventional radiologists can engage with suppliers to reformulate procedure packs to minimize unnecessary items and packaging. Opened but unused equipment can be prevented if there is better communication within the team and increased staff awareness of wasted equipment cost. Incentives to use soon-to-expire equipment can be offered. Power consumption can be reduced by powering down operating room lights and workstations when not in use, changing to Light Emitting Diode (LED) and motion sensor lightings. Surgical hand wash can be replaced with alcohol-based hand rubs to reduce water usage. Common barriers to improving waste management include the lack of leadership, misconceptions regarding infectious risk, lack of data, concerns about increased workload, negative staff attitudes and resistance to change. Education remains a top priority to engage all staff in sustainable healthcare practices.ConclusionInterventional radiologists have a crucial role to play in improving healthcare sustainability. By implementing small, iterative changes to our practice, financial savings, greater efficiency and improved environmental sustainability can be achieved.

Monitoring the effectiveness of surgical handwashing in healthcare workers of a fourth level operating room using bioluminescence assays

Aims: To assesses the effectiveness of surgical handwashing (S-HW) in healthcare workers (HCWs) in terms of organic material and bacteria elimination by means of bioluminescence assays.
 Methods: 62-HCWs were subjected to bioluminescence analyses to determine adenosine triphosphate (ATP) and colony forming units (CFU) of Enterobacteriaceae (EB) and E. coli before and after S-HW. A checklist to evaluate adherence to hand hygiene (HH) protocol was implemented.
 Results: ATP before HH (510.9/RLU) was reduced after S-HW (54.6/RLU), evidencing a significant decrease (p=0.001). Regarding the bacteria, 26.6/CFU and 4/CFU for EB and E. coli were reported before S-HW, respectively. After S-HW, CFU decreased for EB (21.8/CFU) and E. coli (3.5/CFU) without showing a significant reduction (p=0.679). Low ATP did not evidence a direct relation with EB (p=0.082) and E. coli (p=0.680) reduction. Surgical instrument professionals (p=0.001), general surgeons (p=0.001), residents (p=0.017), orthopedists (p=0.029) and otolaryngologists (p=0.029) evidenced a reduction in ATP after S-HW. Factors such as S-HW direction, surgical soap, moments and time of S-HW implemented showed a statistically significant difference in reduction of ATP, but not in CFU.
 Conclusion: Although there was a reduction in elimination of ATP, there was no evidence of a decrease in bacteria. This finding not only allowed to identify potential errors in S-HW processes, but also permitted to generate strategies to improve HH to prevent healthcare-associated infections.

Comparison of Improved Surgical Eight-Step Handwashing Combined with ATP Fluorescence in Detecting the Infection Rate at the Site of Seven-Step Surgical Handwashing and 30-Day Orthopaedic Surgery: A Randomized Study.

Objectives To compare the effects of two hand cleaning schemes on the prevention of surgical site infection in routine orthopaedic surgery. Compared with the standard surgical seven-step washing technique and detected by ATP fluorescence method, the handwashing effects of the improved surgical eight-step washing technique and the standard surgical seven-step washing technique were compared, so as to provide a basis for eliminating the handwashing blind area of the surgical seven step washing technique and improving the surgical handwashing method. Methods A total of 800 consecutive patients who underwent clean and clean-contaminated orthopaedic surgery between January 1, 2020 and December 31, 2020. Twenty orthopaedic doctors in the operating room of our research team were randomly divided into the improved eight-step washing technique group (improved group) and the traditional seven-step washing technique group (traditional group), with 10 people in each group. Each person was randomly sampled 40 times, 400 people in each group, a total of 800 people, and completed by stages in 12 months. Main Outcome Measures. The infection rate of surgical site 30 days after operation was the primary end point. The qualified rate of fingertip culture was combined with ATP fluorescence in the two groups and three new culture areas in the two groups: the lateral edge of the palm, the medial edge of the palm, and the nail groove of the middle finger and the nail root were secondary end points. Results The 2 protocols were comparable in regard to surgical site infection risk factors. The infection rate of surgical site in the traditional group was 10 cases (2.50%) in 400 cases and 0 cases (0%) in the improved group. Three culture areas were added: the qualified rate of lateral edge of palm, medial edge of palm, and nail groove and nail root of middle finger, and the nosocomial infection rate of surgical incision between the two groups was statistically significant (P < 0.05). There was no significant difference in the qualified rate of fingertip culture (P > 0.05). The handwashing scheme in this study meets the recommended duration of hand disinfection and has good tolerance, and the skin dryness and skin irritation after using aqueous solution are similar. Conclusions The improved surgical eight-step washing technique combined with ATP fluorescence detection is helpful to eliminate the “blind area” of handwashing. It is also necessary to add three training areas. Handwashing and training are more scientific, rigorous, and effective. They are effective in reducing orthopaedic surgical infection and have application value. They can safely replace the traditional surgical seven-step washing technique, which is worthy of clinical promotion.

Surgical Hand Washing – A Clinical Audit of Young Surgeons at a Tertiary Care Hospital

Background: Surgical hand washing is the most important preliminary step towards an aseptic surgical approach while dealing the patients. The surgeons know the significance of asepsis, but still they fail to follow the steps of an ideal surgical scrubbing and hand washing technique. Aim: To assess the compliance of standard surgical practices of hand washing technique among young surgeons. Methods: A total of 30 surgical residents were assessed for the compliance of standard surgical practices of hand washing technique randomly. Interventions were made to improve the mistakes and malpractices and inporive the compliance rates of the World Health Organization (W.H.O.) criteria. Data was collected on a computer generated questionnaire. Data was analyzed using the S.P.S.S. 26 version. Results: Only 63% resident surgeons were compliant in following the standard hand washing technique. After intervention, the rates increased to 90.3%. The 30-35 years age group had the best compliance rates. Conclusion: Repeated audits, timely interventions and senior supervisison of the surgical residents regarding the surgical scrubbing and hand washing technique can reduce the malpractices to a minimum level. There is a huge gap in the usual practitces and standard practices. MeSH Words: Hand washing, Asepsis, Surgical scrub, Alcohol, Povidine, Compliance

Level of nurses’ knowledge concerning prevention of hospital-acquired infections in surgical wards

Introduction. Prevention of hospital-acquired infections in surgical wards is associated with a high level of nurses’ knowledge and skills in the area of the observance of procedures, standards of prevention of infections, use of personal protection means, and isolation of patients infected with the alert pathogen. Objective. The aim of the study was recognition of the level of knowledge concerning prevention of hospital-acquired infections among nursing staff in surgical wards. Materials and Method. The study was conducted in 2021, and included 115 nurses employed in hospital wards in two hospitals. The research method was a diagnostic survey, the technique – a questionnaire, and the research tool – an author-constructed questionnaire. Results. The majority of the examined nurses (68.0%) presented a ‘mediocre’ level of knowledge concerning hospital-acquired infections, while 38.9% - a ‘low’ level. More than a half of the respondents (60.0%) knew the purpose for hygienic handwashing. Approximately ¾ of respondents knew that there is no necessity for using sterile gloves during procedures related with the risk of contact with blood or body fluids. The majority of nurses in the study (62.5%) had a deficit of knowledge about transient flora inhabiting the skin, and 1/3 of respondents had no established principles of observance of personal protection means. More than a half of nurses (65.2%) did not know the objective of isolation of patients infected with an alert pathogen. Nearly a half of respondents (47.8%) knew that standard isolation is applied in each patient, irrespective of the previous medical history taking. Almost 2/3 of respondents (64.3%) knew that isolations applied in infections transmitted through contact, by airborne-droplet and airborne-dust routes are the types of above-standard isolation. Conclusions. The results of the study confirm the need for expanding the scope of knowledge about prevention of hospital-acquired infections, the time of hygienic and surgical handwashing, as well as the principles of using personal protection means. The nurses presented a deficit of knowledge concerning transient flora of pathogenic microorganisms inhabiting the surface of the hands, and the principles of using personal protection means. Nurses require the expansion of the scope of knowledge about the goal and principles of standard and above-standard isolation of patients infected with alert pathogen.

The practice of hand hygiene in the maternities of the public hospitals of Lubumbashi

Introduction: The objective of this study was to evaluate the practice of hand hygiene in the maternities of the public hospitals of Lubumbashi. Method and techniques: We carried out a cross-sectional descriptive study in which the population consisted on the one hand of the technical rooms of the maternity hospitals and the operating rooms for cesarean sections and on the other hand the nurses responsible for these maternities. The observation technique using an observation guide of the WHO model allowed us to collect the data. Results: Hand hygiene was not properly carried out in the maternity wards of Lubumbashi's public hospitals. Most of the prerequisites before hand washing and hydro-alcoholic hand rubbing were not respected, the prerequisites for surgical hand washing were observed only at 21.4%:e wearing of short-sleeved clothing (43.0%),absence of jewelry (78.6%), short nails without varnish and false nails (50.0%). In the absence of hydroalcoholic solution (SHA) (71.4%) for the friction, they used denatured alcohol (28.6%). The duration of soaping and friction was in an interval between 11 to 20 seconds or 42.9% and that of hygienic hand washing was observed at 28.6%. The duration of surgical and antiseptic hand washing was 21 to 40 seconds to 35.7%. Only 21.4% of the departments surveyed had used the broad-spectrum antiseptic foaming solution, no structure had a sterile disposable brush for hygienic and surgical hand washing, 2/14 departments surveyed had sterile disposable towels, the water used had not undergone bacteriological control and only one service, ie 7.1%, which had non-manually operated bins. Conclusion: Hand hygiene is not properly carried out in maternity hospitals in Lubumbashi's public hospitals, due to a lack of equipment and knowledge on this practice, equipment must be provided and staff trained in hand hygiene.

Water consumption during pre-operative hand sanitisation: A qi project for the post-COVID-19 world

Context: Water is a scarce and precious resource in many parts of the world. The COVID-19 pandemic has reemphasised the importance of handwashing and sanitisation. The world is moving back to opening the surgical procedures once again. Aims: The aim is to analyse the impact of water consumption and the cost associated with surgical hand sanitisation. Settings and Design: Quality Improvement Project. Subjects and Methods: This is a quality improvement project; members of the surgical team were asked to scrub and amount of flowing water for 5 min was collected in a measuring bucket. The hospital sinks are equipped with either manual or automatic motion sensor taps. This was reflected in the total amount of water and cost that was calculated for the operative cases of 2019. Statistical Analysis Used: Descriptive statistics, calculating the mean. Results: Three minutes was the average scrub time for the six participants. Thirty litres of water were consumed using a manual tap with continuous flow for 5 min. In comparison just 7.5 L of water were consumed using a motion sensor tap. A total of 7060 cases were operated in the year of 2019 with an annual cost that ranged from 1.8 to 7.5 million United Arab Emirates Dirham. Conclusions: The surgical handwashing technique is associated with a considerable amount of water. Motion sensor taps have the advantage to decrease wasting with water flowing only during actual washing. Techniques to decrease that amount are available and can be considered to preserve the water.

Achieving Perfect Hand Washing: an Audit Cycle with Surgical Internees.

The aim of this study is to achieve 100% compliance in surgical hand antisepsis along with identification of areas of worst compliance and efficacies of various interventions best suited to deal with them. This audit was performed over 6 days in a tertiary care hospital in Calcutta, India, with 42 surgical internees. Compliance to ideal hand washing technique was recorded after each attempt with the first attempt as baseline. Video demonstration, personal demonstration by a consultant, and individual instruction were used as subsequent interventions to achieve 100% compliance. The baseline level of compliance was found to be 33.59%. A total of 6 attempts was required to achieve 100% compliance, with the increase in compliance being statistically significant (p = 0.0294). Personal instruction was found to be the most effective intervention. Hand washing technique was the criterion that needed the most number of attempts (n = 6) to rectify. This study found video-based instruction and individual guidance effective teaching tools for surgical hand disinfection and gave novel data regarding the reasons responsible for poor compliance to proper hand washing in a general surgical setting. This study demonstrated the efficiency of audit cycles in the improvement of surgical hand washing and can be the preferred mode of intervention in future studies aimed at achieving ideal hand antisepsis.

Design, Fabrication, and Testing of a Novel Surgical Handwashing Machine.

Background. Surgical hand scrub is strongly recommended as an essential measure to reduce surgical site infections (SSIs). SSI results in morbidity and additional cost. Micropunctures may occur on surgical gloves during operation, thus hand scrub cannot be omitted in any condition. Generally speaking, the adequacy of hand scrub is decided by the surgeon. Only occasionally, surveillance of hygienic status of hands is performed after scrub. Therefore, the potential exists that suboptimal handwash leads to SSIs. There are standards for preoperative handwash, but all of them are operator dependent, and continuous surveillance is actually impossible. One solution is to omit the role of surgeon in handwashing. This can be achieved by designing a standard procedure, performed mechanically by a machine, considering the detailed requirements of hygienic surgical hand scrub. The goal of this study was to develop a procedure that works on the design, fabrication, and trial of a new handwashing machine, for surgical hand scrub. Methods. A machine with a reciprocal spraying mechanism was designed that covers from the fingertips up to the elbow. Various combinations of staged irrigations with antiseptic solutions and water were to be programmed and implemented. Clinical experiments were performed several times with different handwashing programs, and swabs were taken from the skin surface and creases. Results. There was no microbial growth after 72hours with any handwashing program. Conclusion. The preliminary experiments with this new handwashing machine show promising results for its application in surgical hand scrub.

The Role of Sensor-Activated Faucets in Surgical Handwashing Environment as a Reservoir of Legionella.

Surgical handwashing is a mandatory practice to protect both surgeons and patients in order to control Healthcare-Associated Infections (HAIs). The study is focused on Legionella and Pseudomonas aeruginosa contamination in Surgical Handwashing Outlets (SHWOs) provided by sensor-activated faucets with Thermostatic Mixer Valves (TMVs), as correlated to temperature, technologies, and disinfection used. Samples were analyzed by standard culture techniques, comparing hot- and cold-water samples. Legionella isolates were typed by an agglutination test and by mip sequencing. Legionella contamination showed the same distribution between hot and cold samples concerning positive samples and mean concentration: 44.5% and 1.94 Log10 cfu/L vs. 42.6% and 1.81 Log10 cfu/L, respectively. Regarding the distribution of isolates (Legionella pneumophila vs. Legionella non-pneumophila species), significant differences were found between hot- and cold-positive samples. The contamination found in relation to ranges of temperature showed the main positive samples (47.1%) between 45.1–49.6 °C, corresponding to high Legionella concentrations (2.17 Log10 cfu/L). In contrast, an increase of temperature (>49.6 °C) led to a decrease in positive samples (23.2%) and mean concentration (1.64 Log10 cfu/L). A low level of Pseudomonas aeruginosa was found. For SHWOs located in critical areas, lack of consideration of technologies used and uncorrected disinfection protocols may lead to the development of a high-risk environment for both patients and surgeons.

Implementing a multidisciplinary care bundle to reduce colon surgical site infections.

PurposeThe aim of this study was to investigate how rates of surgical site infections (SSI) were changed over 2 years after applying colon SSI bundle in patients who underwent colon surgery.MethodsThe multidisciplinary working group developed a care bundle consisting of 8 components, including several recommendations of Surgical Care Improvement Project and monitoring of medical/surgical hand washing. We implemented the care bundle for each patient who underwent colon surgery from April 2013 to December 2014.ResultsOverall bundle compliance was 87.9% before implementation, 88.2% in 2013, and 90.5% in 2014. In particular, compliance of the following 3 components was substantial improved during the project period; discontinuation of prophylactic antimicrobial agent within 24 hours of surgery (from 88.3% to 100%), surgical hand washing (from 50.0% to 78.9%), and medical hand washing (from 74.7% to 82.8%). The rate of SSI was 8.0% (12/150) during 3 months before implementation, 3.3% (16/480) from April to December in 2013, and 2.3% (14/607) in 2014.ConclusionAfter implementation of multidisciplinary care bundle, the compliance of each component was increased and rates of SSIs were significantly decreased compared to those before the quality improvement project.

Effectiveness of Surgical hand Washing with Chlorhexidine, Providone iodine and Alcohol on Reducing the Microorganisms on the Hands: A Systematic Review

Background: Postoperative infection is one of the causes of mortality and the hands of the surgical team are the most common cause. According to the The Center for Disease Control and Prevention (CDC), proper hand washing can reduce the occurrence of nosocomial infections by up to 30%. The aim of this study is to determine the effectiveness of surgical hand washing using chlorhexidine, providone iodine and alcohol in reducing the microorganisms on the hand.Method: The data was collected from the following electronic databases: Science Direct, Springer link, Scopus and ProQuest. The search obtained 11 articles in accordance with the inclusion criteria and we obtained the literature in full text form.Result: The results of the study found three articles that mentioned hand washing with an alcohol hand rub as being more effective than iodine and chlorhexidine providone. There was one article described that both alcohol hand rub and chlorhexidine are more effective than iodine providone, Another article mentioned that chlorhexidine, providone iodine and alcohol hand rub were equally effective at reducing microorganisms contaminating the hand.Conclusion: The conclusion of the study is that surgical hand washing using chlorhexidine, providone iodine and alcohol are all effective at reducing microorganisms.

Presence of Staphylococcus aureus after surgical hand washing in dentistry students

Objetive: The objective of the present study was to determine the presence of Staphylococcus aureus (S. aureus) in the students of the course of Surgery Buco Maxilo Facial I of the Faculty of Dentistry-USMP after the surgical hand washing. Materials and Methods: Students were divided into 4 groups: Group A: Students who performed the technique of surgical hand-washing with a brush using chlorhexidine soap, Group B: Students who performed the technique of surgical hand washing by friction (without brush) using chlorhexidine soap, Group C: Students who performed the technique of surgical hand-washing with a brush using glycerin soap, Group D: Students who performed the technique of surgical hand washing by friction (without brush) using glycerin soap. In each group the presence of S. aureus was determined and compared between the four. Results: In all of groups there was presence of S. aureus , but in the technique of group B there was less quantity. Conclusions: Many people are carriers of S. aureus in their hands. The most recommended surgical hand washing technique is the friction technique (without brush), using chlorhexidine soap.

Two-Layer Wound Sealing before Surgical Hand Washing for Surgeons with a Minor Cut Injury on the Hand.

Background: There is a lack of evidence-based recommendations for surgical hand washing when there is a minor cut on the hand. We sought to evaluate whether two-layer wound sealing functions as a barrier to prevent the spread of micro-organisms. Methods: We randomly categorized 20 surgeons into subjects with either a right- or left-hand injury. Each subject was assumed to have a minor injury on the assigned hand and the other hand was used as a control. Subjects applied a waterproof topical dressing as a first layer, then protected the injured area with a second layer using an antimicrobial drape, and finally performed surgical hand rubbing. Subjects stamped each hand onto an agar plate. The injured hands were checked by an investigator to confirm the wounded area remained properly sealed after hand rubbing. Colonies were counted and the micro-organisms were identified after 48 hours of incubation. Results: There was no leak found from two-layer wound sealing after hand washing. Mean number of the colonies was 0.2 on the injured hand and 0.25 on the uninjured hand (p = 0.772). The micro-organisms cultured from both the injured and uninjured hands were coagulase-negative staphylococci. Conclusions: Using a model for a minor cut injury on the hand this study demonstrated that two-layer wound sealing is an effective barrier not only to prevent the spread of micro-organisms but also to protect surgeons.