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Volume 48, Number 3, June 2015

Comparative antimicrobial efficacy of alcohol-based hand rub and conventional surgical scrub in a medical center 


Ni-Jiin Shen, Sung-Ching Pan, Wang-Huei Sheng, Kwei-Lian Tien, Mei-Ling Chen, Shan-Chwen Chang, Yee-Chun Chen


Received: April 29, 2013    Revised: July 30, 2013    Accepted: August 13, 2013   

 

Corresponding author:

Wang-Huei Sheng
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
Correspondence
Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei 100, Taiwan. 



 

Background and purpose: 

Hand hygiene is the cornerstone of aseptic techniques to reduce surgical site infection. Conventional surgical scrub is effective for disinfecting a surgeon's hands. However, the compliance of conventional scrub may be hindered by skin damage, allergy, and time. Alcohol-based hand rub has a satisfactory antimicrobial effect, but mostly in laboratory settings. Our aim was to compare a conventional surgical scrub with an alcohol-based hand rub to evaluate antimicrobial efficacy. 



 

Methods:

From June 1, 2010 to July 31, 2011, 128 healthcare workers were enrolled in the study. They used an alcohol-based hand rub or a conventional surgical scrub as preoperative hand antisepsis during their routine practice. Hand sampling for cultures were performed before and after operations. Positive culture plates were further processed for pathogen identification. 



 

Results:

The culture positive rate of the alcohol-based hand rub was 6.2% before operations and 10.8% after operations. Both rates were lower than the conventional surgical scrub [47.6% before operations (p < 0.001) and 25.4% after operations (p = 0.03)]. The most identified pathogens were Gram-positive with coagulase-negative staphylococci being the major pathogen. Multivariate analysis showed that prior hand condition (p = 0.21) and type of surgery such as cardiovascular surgery (p = 0.12) were less relevant, but the alcohol-based hand rub was a significant protective factor for positive hand cultures. 



 

Conclusion:

The alcohol-based hand rub was more efficacious for surgical antisepsis and had sustained efficacy, compared to conventional surgical scrub. We suggest that alcohol-based hand rubs could be an alternative surgical antiseptic in the operative theater. 



 

Key words:

Alcohol-based hand rub, Surgical antisepsis, Surgical site infection