title: Randomized Controlled Trial of Antiseptic Hand Hygiene Methods in an Outpatient Surgery Clinic.
abstract: BACKGROUND
  Outpatient wound care plays an integral part in any plastic surgery practice. However, compliance with hand hygiene measures has shown to be low, due to skin irritation and lack of time. The objective of this trial was to determine whether single-use, long-acting antiseptics can be as effective as standard multiple-use hand hygiene methods in an outpatient surgical setting.
  
  
  METHODS
  A prospective, randomized controlled trial was performed in the authors' outpatient plastic surgery clinic at Rutgers New Jersey Medical School, Newark, NJ to compare the efficacy of an ethyl alcohol-based sanitizer (Avagard D Instant Hand Aniseptic, 3M Health Care, St. Paul, MN), a benzalkonium chloride-based sanitizer (Soft & Shield, Bioderm Technologies, Inc, Trenton, NJ, distributed by NAPP Technologies, Hackensack, NJ ), and soap and- water handwashing. Subjects included clinic personnel, who were followed throughout the course of a 3-hour clinic session with hourly hand bacterial counts taken.
  
  
  RESULTS
  During the course of the trial, 95 subjects completed the clinic session utilizing 1 of the hand hygiene methods (36 ethyl alcohol-based sanitizer, 38 benzalkonium chloride-based sanitizer, and 21 soap-and-water handwashing). There was no difference between hand bacterial counts using the different methods at 4 hourly time points (P greater than 0.05). Hand bacterial counts increased significantly over the 3-hour clinic session with the ethyl alcohol-based sanitizer (9.24 to 21.90 CFU, P less than 0.05), benzalkonium chloride-based sanitizer (6.69 to 21.59 CFU, P less than 0.05), and soap-and-water handwashing (8.43 to 22.75 CFU, P less than 0.05).
  
  
  CONCLUSIONS
  There does not appear to be any difference in efficacy between single-use, long-acting sanitizer, and standard multiple-use hand hygiene methods. Hand bacterial counts increased significantly over the course of the 3-hour clinic session regardless of the hand hygiene measure used. Hand condition of subjects was improved with the ethyl alcohol-based sanitizer and the benzalkonium chloride-based sanitizer compared with soap-and-water handwashing.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Therattil
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Janet H
authors.initials: JH
authors.lastname: Yueh
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Kordahi
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Deepa V
authors.initials: DV
authors.lastname: Cherla
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Granick
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D002710:Chlorhexidine / Q000031:analogs & derivatives; D003187:Compliance; D000431:Ethanol; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012915:Soaps; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D012915:Soaps; D000431:Ethanol; C010882:chlorhexidine gluconate; D002710:Chlorhexidine