Surgical hand scrubs in relation to microbial counts: systematic literature review.
ABSTRACT This paper reports a systematic review whose objective was to determine the effectiveness of surgical hand scrubs in relation to bacterial growth on the hands of operating room staff members.
Despite the need for surgical hand scrubs, evidence shows that frequent and prolonged use of antiseptics and brushes may damage the skin. Consequently, lesions may appear, become more heavily colonized by microorganisms and increase the risk of transmitting infection to patients. Recommendations about surgical hand scrubs vary widely and their effectiveness in relation to microbial counts is unknown.
A variety of healthcare databases were searched covering the period between January 1990 and December 2004. Based on selection criteria, the abstracts of studies identified were checked to determine whether they fulfilled the inclusion criteria. All studies were assessed as having adequate methodological quality. Using Cochrane Review Manager 4.2 software, weighted mean difference and 95% confidence intervals were calculated.
Three studies were included in this review. Two studies compared the effectiveness of surgical hand scrubs using an alcohol-based product and a 6-minute scrub using 4% chlorhexidine gluconate; meta-analysis showed a statistically significant difference (weighted mean difference = -0.63, 95% confidence intervals = -0.99 to -0.27, P = 0.0006). One study compared the effectiveness of 2- and 3-minute surgical hand scrubs using 4% chlorhexidine gluconate; meta-analysis showed no difference (weighted mean difference = 0.29, 95% confidence intervals = -0.13 to 0.71, P = 0.18).
Surgical hand scrubs using an alcohol-based product were more effective than a 6-minute scrub using 4% chlorhexidine gluconate. There is no evidence to support a 2-minute surgical hand scrub as being more effective than a 3-minute one using 4% chlorhexidine gluconate.
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ABSTRACT: Surgical site infections are an inherent risk in orthopaedic surgery and many of the infections that develop are likely to be non-preventable. However, a variety of measures can be undertaken to reduce the risk and impact of surgical site infections. The development and implementation of an infection control program, including surgical site infection surveillance, can be an important tool for patient management. All veterinary practices should have some form of infection control program in order to address surgical site infections, among other issues, and to provide the optimal and expected level of care.Veterinary and Comparative Orthopaedics and Traumatology 02/2008; 21(2):99-105. · 0.81 Impact Factor