Bactericidal efficacy of a 1.5 min surgical hand-rubbing protocol under in-use conditions

SummaryIn healthy volunteers, surgical hand rubbing with Sterillium® for 1.5 min has been shown to be as effective as a 3 min procedure. The aim of this study was to assess whether this result was reproducible under in-use conditions. During nine weeks in the ambulatory surgery theatre of a 750-bed tertiary care university hospital, the two surgical hand-rubbing procedures were compared with each other, and with a hand-scrubbing procedure using a povidone-iodine (4%) scrub prior to and after 25 different surgical operations for each. Imprints of the surgeon's dominant hand were taken on culture plates before and within 1 min following the end of the hand-rubbing/scrubbing procedures (immediate effect) and at the end of surgery (sustained effect). Plates were incubated aerobically at 37 °C for 48 h. Colonies were counted at 24 h and 48 h. Results were expressed as the number of colony-forming units per hand. No significant difference in baseline hand bacterial load was found before the hand-rubbing/scrubbing procedures among the three groups (P = 0.19). With respect to immediate and sustained antimicrobial effects, a significantly greater reduction in microbial loads on the hands was achieved with the 3 min hand-rubbing protocol as opposed to hand-scrubbing protocol (P = 0.04 and P = 0.02, respectively), but there was no difference between the reductions obtained with 1.5 and 3 min rubbing protocols (P = 0.41 and P = 0.36, respectively). Surgical hand rubbing with Sterillium using a 1.5 min protocol should be considered as an attractive alternative method for surgical hand disinfection.