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Study shows hand-rubbing solution safe alternative
A recent study published in the Journal of the American Medical Association (JAMA) found that hand rubbing with a liquid aqueous alcoholic solution can be safely used as an alternative to traditional surgical hand scrubbing.1
The study included 4,387 consecutive patients who underwent surgery between Jan. 1, 2000, and May 1, 2001, at six surgical services at hospitals in France. The surgical services used two hand-cleansing methods alternately every month. They were a hand-rubbing protocol with 75% aqueous alcoholic solution containing propanol-1, propanol-2, and mecetronium etilsulfate; and a hand-scrubbing protocol with antiseptic preparation containing 4% povidone iodine or 4% chlorhexidine gluconate. The main outcome measures were 30-day surgical site infection rates, as well as the operating room teams’ tolerance of and compliance with hand washing.
The two protocols were comparable in terms of surgical site infection risk factors. Surgical site infection rates were 55 of 2,252 (2.44%) in the hand-rubbing protocol and 53 of 2,135 (2.48%) in the hand-scrubbing protocol. The difference was 0.04% (95% confidence interval, - 0.88% to 0.96%).
Hand rubbing with aqueous alcoholic solution was preceded by a one-minute nonantiseptic hand wash before each surgeon’s first procedure of the day and before any other procedure if the hands were soiled. This protocol was as effective as traditional hand scrubbing with antiseptic soap in preventing surgical site infections, the authors conclude.
Based on subsets of personnel, compliance with the recommended duration of hand antisepsis was better in the hand-rubbing protocol than with the hand-scrubbing protocol (44% vs. 28%, respectively; P = .008). Tolerance also was better, with less skin dryness and less skin irritation after aqueous solution use, the authors report.
1. Parienti JJ, Thibon P, Heller R. Hand-rubbing with an aqueous alcoholic solution vs. traditional surgical hand-scrubbing and 30-day surgical site infection rates. JAMA 2002; 288:722-727.