Recommendations for surgical hand disinfection—requirements, implementation and need for research. A proposal by representatives of the SFHH, DGHM and DGKH for a European discussion

Labadie, Jean-Claude; Kampf, G; Lejeune, B.; Exner, Martin; Cottron, O.; Girard, R.; Orlick, M.; Goetz, M.L.; Darbord, J. C.; Krämer, Axel

doi:10.1053/jhin.2002.1243

Cited by 48 publications

(31 citation statements)

References 22 publications

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“…For preoperative treatment of hands, however, no clear recommendation was provided in the United States guideline (3), although remarkable differences in the effects on resident hand bacteria were described for different agents (6). In Europe, however, alcohol-based hand rubs are thought to have better efficacy and to result in better dermal tolerance and are therefore preferred to antimicrobial soaps (15). There are two principal options for preoperative treatment of hands: use of an alcohol-based hand rub (surgical hand disinfection) or use of an antimicrobial liquid soap (surgical hand scrub).…”

mentioning

confidence: 99%

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Kampf

Ostermeyer

2004

Appl Environ Microbiol

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For assessment of the efficacy of surgical hand disinfection, European reference method prEN 12791 prescribes that the hands must be kept wet with the reference alcohol for 3 min regardless of the applied volume. The aim of this study was to determine whether the applied volume of the reference disinfectant n-propanol (60%, vol/vol) influences the effect on the resident hand flora. Ten experiments with 200 reference disinfections were analyzed. Hands were washed for 1 min with soap. The bacterial prevalue was obtained by rubbing fingertips in tryptic soy broth for 1 min. After this, each subject treated the hands with n-propanol (60%, vol/vol) by using as many portions as necessary to keep hands wet for a total of 3 min. Bacterial postvalues (immediate effect) were obtained for one hand, and the other hand was gloved for 3 h. After the gloves were taken off, a second postvalue was obtained (sustained effect). Most surgical reference disinfections (73%) were achieved with 9 ml of the reference alcohol, followed by 12 ml (24%) and 6 ml (3%). There was no significant difference between the mean log 10 reduction values for the three treatment groups, both in terms of the immediate effect (P ‫؍‬ 0.333, as determined by analysis of variance) and in terms of the sustained effect (P ‫؍‬ 0.442). A higher number of portions did not correlate with a higher reduction factor (for immediate effect, Pearson's correlation coefficient ‫؍‬ ؊0.028 [P ‫؍‬ 0.689]; for sustained effect, Pearson's correlation coefficient ‫؍‬ 0.059 [P ‫؍‬ 0.404]). If the hands were kept wet with the reference alcohol for the total application time, the applied volume could vary, but this did not alter the efficacy.

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mentioning

confidence: 99%

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Kampf

Ostermeyer

2004

Appl Environ Microbiol

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“…529,531 Viruses are rarely involved in SSI and are not part of test procedures for licensing in any country. Similarly, activity against spore-producing bacteria is not part of international testing procedures.…”

Section: Objective Of Surgical Hand Preparationmentioning

confidence: 99%

“…Several alcohol-based handrubs have been licensed for the commercial market, 531,556,557 frequently with additional, longacting compounds (e.g. chlorhexidine gluconate or quaternary ammonium compounds) limiting regrowth of bacteria on the gloved hand, 377,529,[558][559][560][561] The antimicrobial efficacy of alcoholbased formulations is superior to that of all other currently available methods of preoperative surgical hand preparation.…”

Section: Surgical Hand Preparation With Alcohol-based Handrubsmentioning

confidence: 99%

“…While this handwash may eliminate any risk of contamination with bacterial spores, experimental and epidemiological data failed to demonstrate an additional effect of washing hands before applying handrub in the overall reduction of the resident skin flora. 531 The activity of the handrub formulation may even be impaired if hands are not completely dried before applying the handrub or by the washing phase itself. 562,564,565 A simple handwash with soap and water before entering the operating theatre area is highly recommended to eliminate any risk of colonization with bacterial spores.…”

Section: Surgical Hand Preparation With Alcohol-based Handrubsmentioning

confidence: 99%

“…This simple procedure appears not to require training, though two studies provide evidence that training significantly improves bacterial killing. 531,567 The hands should be wet from the alcohol-based rub during the whole procedure, which requires approximately 15 ml depending on the size of the hands. One study demonstrated that keeping the hands wet with the rub is more important than the volume used.…”

Section: Technique For the Application Of Surgical Hand Preparation Umentioning

confidence: 99%

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