Hand washing in operating room: a procedural comparison

BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order...

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Main Authors: Alessia Stilo, Gianmarco Troiano, Lucia Melcarne, Maria Eufemia Gioffrè, Nicola Nante, Gabriella Messina, Pasqualina Laganà
Format: Article
Language:English
Published: Milano University Press 2016-09-01
Series:Epidemiology, Biostatistics and Public Health
Online Access:http://ebph.it/article/view/11734
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author Alessia Stilo
Gianmarco Troiano
Lucia Melcarne
Maria Eufemia Gioffrè
Nicola Nante
Gabriella Messina
Pasqualina Laganà
author_facet Alessia Stilo
Gianmarco Troiano
Lucia Melcarne
Maria Eufemia Gioffrè
Nicola Nante
Gabriella Messina
Pasqualina Laganà
author_sort Alessia Stilo
collection DOAJ
description BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO), and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed) for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL) and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction), washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction) and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction). CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing)  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infections
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spelling doaj-art-c78d71d3c9f04c7394074a519fdb9bcf2025-08-20T03:22:57ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302016-09-0113310.2427/1173410698Hand washing in operating room: a procedural comparisonAlessia Stilo0Gianmarco Troiano1Lucia Melcarne2Maria Eufemia Gioffrè3Nicola Nante4Gabriella Messina5Pasqualina Laganà6School of Public Health, University of MessinaUniversity of SienaSchool of Public Health, University of MessinaSchool of Public Health, University of MessinaSchool of Public Health University of SienaSchool of Public Health University of SienaDepartment of Biomedical Sciences and Morphological and Functional Images, University of MessinaBACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO), and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed) for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL) and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction), washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction) and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction). CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing)  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infectionshttp://ebph.it/article/view/11734
spellingShingle Alessia Stilo
Gianmarco Troiano
Lucia Melcarne
Maria Eufemia Gioffrè
Nicola Nante
Gabriella Messina
Pasqualina Laganà
Hand washing in operating room: a procedural comparison
Epidemiology, Biostatistics and Public Health
title Hand washing in operating room: a procedural comparison
title_full Hand washing in operating room: a procedural comparison
title_fullStr Hand washing in operating room: a procedural comparison
title_full_unstemmed Hand washing in operating room: a procedural comparison
title_short Hand washing in operating room: a procedural comparison
title_sort hand washing in operating room a procedural comparison
url http://ebph.it/article/view/11734
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