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Antiseptic Effect of Conventional Povidone–Iodine Scrub, Chlorhexidine Scrub, and Waterless Hand Rub in a Surgical Room: A Randomized Controlled Trial

Published online by Cambridge University Press:  20 December 2016

Jui-Chen Tsai
Affiliation:
Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
Yen-Kuang Lin
Affiliation:
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan Biostatistics Center, Taipei Medical University, Taipei, Taiwan
Yen-Jung Huang
Affiliation:
Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
El-Wui Loh
Affiliation:
Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Hsiao-Yun Wen
Affiliation:
Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Chia-Hui Wang
Affiliation:
Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
Yin-Tai Tsai
Affiliation:
Department of Laboratory Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Wen-Shyang Hsieh
Affiliation:
Department of Laboratory Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan Department of Education, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan
Ka-Wai Tam*
Affiliation:
Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan Department of Surgery, School of Medicine, College of Medicine, Taipei Medical, University, Taiwan Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
*
Address correspondence to Ka-Wai Tam, MD, PhD, Center for Evidence-Based Health Care, Taipei Medical University—Shuang Ho Hospital, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan (kelvintam@h.tmu.edu.tw).

Abstract

OBJECTIVE

Effective perioperative hand antisepsis is crucial for the safety of patients and medical staff in surgical rooms. The antimicrobial effectiveness of different antiseptic methods, including conventional hand scrubs and waterless hand rubs, has not been well evaluated.

DESIGN, SETTING, AND PARTICIPANTS

A randomized controlled trial was conducted to investigate the effectiveness of the 3 antiseptic methods among surgical staff of Taipei Medical University—Shuang Ho Hospital. For each method used, a group of 80 participants was enrolled.

INTERVENTION

Surgical hand cleansing with conventional 10% povidone–iodine scrub, conventional 4% chlorhexidine scrub, or waterless hand rub (1% chlorhexidine gluconate and 61% ethyl alcohol).

RESULTS

Colony-forming unit (CFU) counts were collected using the hand imprinting method before and after disinfection and after surgery. After surgical hand disinfection, the mean CFU counts of the conventional chlorhexidine (0.5±0.2, P<0.01) and waterless hand rub groups (1.4±0.7, P<0.05) were significantly lower than that of the conventional povidone group (4.3±1.3). No significant difference was observed in the mean CFU count among the groups after surgery. Similar results were obtained when preexisting differences before disinfection were considered in the analysis of covariance. Furthermore, multivariate regression indicated that the antiseptic method (P=.0036), but not other variables, predicted the mean CFU count.

CONCLUSIONS

Conventional chlorhexidine scrub and waterless hand rub were superior to a conventional povidone–iodine product in bacterial inhibition. We recommend using conventional chlorhexidine scrub as a standard method for perioperative hand antisepsis. Waterless hand rub may be used if the higher cost is affordable.

Infect Control Hosp Epidemiol 2017;38:417–422

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

TRIAL REGISTRATION. clinicaltrials.gov Identifier: NCT02294604

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