An in-use evaluation of an alcohol-based pre-surgical hand disinfectant.
OBJECTIVE
To determine whether alcohol hand disinfection is an effective alternative to traditional agents for the pre-surgical scrub.


METHODS
A prospective clinical trial of a 70% isopropanol pre-surgical hand disinfectant.


METHODS
The operating room suites at two hospital sites in British Columbia.


METHODS
Cases were selected to evaluate both short and longer procedures. The hand disinfectant was compared to agents in current use as surgical scrubs (4% chlorhexidine and 7.5% povidone-iodine). Surgical technique and glove use were not modified. Pre- and postoperative fingertip impression and "glove-juice" cultures were used to determine microbial burden, and hands were evaluated for skin integrity.


RESULTS
There was no statistical difference between the microbial hand counts following use of the alcohol-based product or the current agents, for cases less than 2 hours' duration. Comparison of longer surgical cases revealed significantly better pre- and postoperative culture results with the alcohol hand rinse, but analysis of matched pairs showed no significant difference in microbial counts. The alcohol hand rinse was equivalent to the operative scrub in terms of skin integrity and user acceptability.


CONCLUSIONS
An alcohol hand rinse was equivalently effective in reducing microbial hand counts as the traditional pre-surgical scrub, both immediately after hand disinfection and at the end of the surgical procedure.
Bryce
E A
EA
Division of Infection Control/Medical Microbiology, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
Spence
D
D
Roberts
F J
FJ
D019840:2-Propanol / Q000592:standards*; D001955:British Columbia; D002710:Chlorhexidine / Q000592:standards; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000592:standards*; D006235:Hand Disinfection; D006801:Humans; D009873:Operating Rooms; D011206:Povidone-Iodine / Q000592:standards; D011300:Preoperative Care; D011446:Prospective Studies; D012997:Solvents / Q000592:standards*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*
D004202:Disinfectants; D012997:Solvents; D011206:Povidone-Iodine; D019840:2-Propanol; D002710:Chlorhexidine