title: Practice of skin protection and skin care among German surgeons and influence on the efficacy of surgical hand disinfection and surgical glove perforation.
abstract: BACKGROUND
  Surgical hand rub and healthy skin are basic requirements to prevent surgical site infections. Nevertheless, there is little knowledge about the current practice of skin protection and/or skin care products (SP/SC) using among surgeons as well as a lack of data pertaining to the influence of SP/SC on the antimicrobial efficacy of surgical hand rub.
  
  
  METHODS
  A 10 weeks-survey among German surgeons as well as an experimental crossover study involving 26 participants were conducted. The immediate and sustainable efficacy (IE/SE) of surgical hand rub and participants' hand moisture were measured after an 8-day usage of SP/SC, as well as the influence on micro-perforations on surgical gloves.
  
  
  RESULTS
  The questionnaire was available to 16,000 German surgeons. Thereof, 1,771 surgeons accessed the questionnaire, representing a total participation rate of 11%. As 19% (n = 338) of questionnaires were incomplete, a total of 1,433 completed questionnaires were available for further analysis. More than 75% of the participants stated not to use any SP/SC, yet, almost 50% suffered from skin irritation or discomfort. Only 5% used SP/SC at the beginning of their shift. 10% refused to use SP/SC because of concerns that SP/SC may reduce the antimicrobial efficacy of surgical hand rub.After usage of SP/SC over 8-days, skin moisture was significantly higher (P < 0.001), whereas no significant influence on the antimicrobial efficacy of surgical hand rub was observed (IE: P = 0.135; SP: P = 0.681). Micro-perforations were detected in 8/52 surgical gloves (15%), with no statistical significant difference between SP/SC users (n = 2/26; 8%) and non-users (n = 6/26; 23%; P = 0.249).
  
  
  CONCLUSIONS
  Following the results of this largest questionnaire base survey among German surgeons on skin care, there is a need to educate and inform surgeons on the correct application and the concept of SP/SC strategies. In the present study, the combination of selected SP/SC products and one alcohol-based hand rub formulation did not show a negative interaction with surgical hand rub or surgical glove perforation. However, it is advisable to ascertain the compatibility of SP/SC products with the used hand disinfectant prior to purchase.
authors.forename: Julian C
authors.initials: JC
authors.lastname: Harnoss
authors.forename: Laura
authors.initials: L
authors.lastname: Brune
authors.forename: Jörg
authors.initials: J
authors.lastname: Ansorg
authors.forename: Claus-Dieter
authors.initials: CD
authors.lastname: Heidecke
authors.affiliation: Clinical Institute for Hospital Hygiene and Infection Control, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria. ojan.assadian@meduniwien.ac.at.
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003625:Data Collection; D000431:Ethanol; D005260:Female; D005858:Germany; D005932:Gloves, Surgical; D006225:Hand; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017592:Skin Care / Q000379:methods* / Q000706:statistics & numerical data; D066231:Surgeons; D013530:Surgical Wound Infection / Q000517:prevention & control; D011795:Surveys and Questionnaires
chemical_list: D000431:Ethanol