title: Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital.
abstract: The antiseptic effectiveness and acceptability of a commercial alcohol-based waterless (ABWL) and an alcohol-based water-aided (ABWA) scrub solution were compared with a brush-based iodine solution (BBIS) under conditions encountered in community hospital operating rooms. This randomized partially blinded study was based on guidelines from the American Society for Testing and Methods. The three scrub solutions were compared for antimicrobial efficacy, using criteria within the Food and Drug Administration's Tentative Final Monograph for Healthcare Antiseptic Products (FDA-TFM), and for participants' acceptance of the products. Volunteer surgical staff that worked daily in the same operating room for the entire duration of the study were enrolled. In total, 1126 surgical scrub procedures were performed over the duration of the study. Only the ABWL met all of the FDA-TFM criteria. The BBIS performed better than both of the alcohol-based solutions at the end of Day 1 (P=0.03), but the ABWL was more efficacious than the ABWA and the BBIS at the end of Days 2 and 5 (P=0.02 and 0.01, respectively). When colony-count reductions were compared over the entire duration of the study, there was no significant difference between the three solutions (P=0.2). The participants found the ABWL easiest to use (P<0.001), with the fewest adverse effects on skin (P=0.007), and it was their preferred product (P<0.001). Although both of the commercially available alcohol-based solutions may be considered as acceptable alternatives to the BBIS for presurgical antisepsis, the ABWL was found to have significantly higher user acceptability.
authors.affiliation: St. John North Shores Hospital, Harrison Township, Michigan, USA. chakgupta@yahoo.com
authors.forename: C
authors.initials: C
authors.lastname: Gupta
authors.forename: A M
authors.initials: AM
authors.lastname: Czubatyj
authors.forename: L E
authors.initials: LE
authors.lastname: Briski
authors.forename: A K
authors.initials: AK
authors.lastname: Malani
mesh_terms: D000891:Anti-Infective Agents, Local / Q000737:chemistry / Q000494:pharmacology*; D000985:Antisepsis / Q000379:methods; D000431:Ethanol / Q000494:pharmacology*; D005932:Gloves, Surgical / Q000382:microbiology; D006225:Hand / Q000382:microbiology; D006235:Hand Disinfection / Q000379:methods*; D006764:Hospitals, Community; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009873:Operating Rooms; D011206:Povidone-Iodine / Q000494:pharmacology*; D016037:Single-Blind Method; D013542:Sweat / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol; D011206:Povidone-Iodine