title: Comparing sterile bag rubbing and paint on technique in skin  preparation of the hands.
abstract: BACKGROUND
  The aim of this study was to compare two techniques for surgical site skin preparation in hand surgery.
  
  
  METHODS
  We compared the standard sponge paint technique versus a plastic bag immersion technique using a 10% povidone-iodine with alcohol solution (Betadine, ORION Laboratories Pty Ltd, Balcatta,WA,Australia) to prepare surgical site skin for hand surgery. This sterile bag rubbing technique involves using a sterile plastic bag filled with 60 mL of Betadine solution to immerse the subjects' hand. Samples were taken from 10 subjects for bacteria colony-forming unit (CFU) counts before and 3 min after surgical site preparation in each group. Outcome measures were preparation time and CFU reduction with a plate impression test using commercially available agar slides.
  
  
  RESULTS
  The sterile bag rubbing technique significantly reduced (P < 0.0001) the time required for surgical site skin preparation (28 s) compared with the standard technique (86 s). Both techniques were found to have similar efficacy in the reduction of CFU.
  
  
  CONCLUSIONS
  The sterile bag rubbing technique is a quicker alternative method for surgical site preparation in hand surgery and has comparable efficacy to the widely practised standard paint-on technique.
authors.affiliation: Department of Orthopaedic Surgery, Whangarei Hospital, Whangarei, New Zealand. choch550@gmail.com
authors.forename: Justin
authors.initials: J
authors.lastname: Chou
authors.forename: Anwar
authors.initials: A
authors.lastname: Choudhary
authors.forename: Raminder S
authors.initials: RS
authors.lastname: Dhillon
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D015169:Colony Count, Microbial; D004203:Disinfection / Q000379:methods*; D006225:Hand / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods*; D012867:Skin / Q000382:microbiology; D017592:Skin Care / Q000379:methods; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine