title: Clean and green: saving water in the operating theatre.
abstract: BACKGROUND
  There is a growing trend to use alcohol-based hand disinfectants in clinical practice. In addition to their anti-bacterial efficacy, these disinfectants offer an alternative to traditional surgical hand disinfection agents that can save water in the operating theatre.
  
  
  METHODS
  The amounts of water and soap used during traditional surgical hand disinfection with antiseptic soap preparations were measured and water usage over a 1-year period was estimated. Costs of traditional disinfection agents were compared with alcohol-based agents.
  
  
  RESULTS
  One surgical hand disinfection episode with traditional agents used 18.5 l of water. During 15,500 procedures performed at our institution over a 1-year period, 931,938 l of water were used which could have been saved had alcohol-based agents been used. Cost per episode of hand disinfection depends on the amounts used and is not higher compared to traditional agents.
  
  
  CONCLUSIONS
  The benefits of using an alcohol-based surgical hand disinfectant may include significant water savings, in addition to previously published advantages of improved efficacy. When deciding on the method of surgical hand disinfection, careful thought should be given to the use of water as a resource. Surgeons should be aware of the environmental impact of their profession.
authors.affiliation: Department of General Surgery, Worthing Hospital, Worthing, UK. karlheinzjehle@hotmail.com
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Jehle
authors.forename: Nick
authors.initials: N
authors.lastname: Jarrett
authors.forename: Shaun
authors.initials: S
authors.lastname: Matthews
mesh_terms: D000438:Alcohols; D000891:Anti-Infective Agents, Local; D003247:Conservation of Natural Resources; D004202:Disinfectants; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D009873:Operating Rooms; D012915:Soaps; D013514:Surgical Procedures, Operative / Q000379:methods*; D014867:Water
chemical_list: D000438:Alcohols; D000891:Anti-Infective Agents, Local; D004202:Disinfectants; D012915:Soaps; D014867:Water