An evaluation of five protocols for surgical handwashing in relation to skin condition and microbial counts

Journal of Hospital Infection

Volumn 36, Issue 1, 1997, Pages 49-65

  Pereira, L J ^a,b   Lee, G M ^a   Wade, K J ^a  

^a UNIVERSITY OF SYDNEY   (Australia)

^b New South Wales Government   (Australia)

Author keywords

Chlorhexidine; Hand washing; Surgical hand disinfection; Testing antiseptics

Indexed keywords

2 PROPANOL; ALCOHOL; ANTIINFECTIVE AGENT; CHLORHEXIDINE GLUCONATE; POVIDONE IODINE; TRICLOSAN;

ARTICLE; BACTERIAL COUNT; CLINICAL PROTOCOL; CLINICAL TRIAL; COLONY FORMING UNIT; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROSSOVER PROCEDURE; DISINFECTION; HAND WASHING; HUMAN; HUMAN EXPERIMENT; INTERMETHOD COMPARISON; NORMAL HUMAN; NURSE; OPERATING ROOM; RANDOMIZED CONTROLLED TRIAL; SKIN; TIME;

EID: 0030960426     PISSN: 01956701     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0195-6701(97)90090-6     Document Type: Article

References (43)

1. Larson E. Handwashing and skin. Physiologic and bacteriologic aspects. Infect Control 1985; 6: 14-23.
2. Mitchell KG, Rawluk DJR. Skin reactions related to surgical scrub-up: results of a Scottish survey. Br J Surg 1984; 71: 223-224.
3. Larson E, Killien M. Factors influencing handwashing behavior of patient care personnel. Am J Infect Control 1982; 10: 93-99.
4. McLane C, Chenelly S, Sylwestrack ML, Kirchhoff KT. A nursing practice problem: failure to observe aseptic technique. Am J Infect Control 1983; 11: 178-182.
5. Dineen P. An evaluation of the duration of the surgical scrub. Surg Gynecol Obstet 1969; 129: 1181-1185.
6. Galle PC, Homesley HD, Rhyne AL. Reassessment of the surgical scrub. Surg Gynecol Obstet 1978; 147: 215-218.
7. Tucci VJ, Stone AM, Thompson C, Isenberg HD, Wise L. Studies of the surgical scrub. Surg Gynecol Obstet 1977; 145: 415-416.
8. Pereira LJ, Lee GM, Wade KJ. The effect of surgical handwashing routines on the microbial counts of operating room nurses. Am J Infect Control 1990; 18: 354-364.
9. Kappstein I, Schulgen G, Waninger J, Daschner F. Microbiological and economic investigation regarding shortening the procedure for surgical hand disinfection. Chirurg 1993; 64: 400-405.
10. Ayliffe GAJ. Surgical scrub and skin disinfection. Infect Control 1984; 5: 23-27.
11. Daschner FD. How cost-effective is the present use of antiseptics? J Hosp Infect 1988; 11 (Suppl. A): 227-235.
12. Lowbury EJL, Lilly HA. Gloved hand as applicator of antiseptic to operation sites. Lancet 1975; 2: 153-156.
13. Ojajärvi J. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing. J Hyg (Camb) 1980; 85: 193-203.
14. Sebben JE. Surgical antiseptics. J Am Acad Dermatol 1983; 9: 759-765.
15. Rotter M, Koller W, Wewalka G. Povidone-iodine and chlorhexidine gluconate containing detergents for disinfection of hands. J Hosp Infect 1980; 1: 149-158.
16. Rotter ML. Povidone-iodine and chlorhexidine gluconate containing detergents for disinfection of hands. J Hosp Infect 1981; 2: 273-280.
17. Murie JA, Macpherson SG. Chlorhexidine in methanol for the preoperative cleansing of surgeons' hands: a clinical trial. Scott Med J 1980; 25: 309-311.
18. Cronin WA, Gröschel DHM. A no-rinse alcohol antiseptic and a no-touch dispenser for hand decontamination. Infect Control Hosp Epidemiol 1989; 10: 80-83.
19. Steere AC, Mallison GF. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med 1975; 83: 683-690.
20. Berman RE, Knight RA. Evaluation of hand antiseptics. Arch Environ Health 1969; 18: 781-783.
21. Jones MV, Rowe GB, Jackson B, Pritchard NJ. The use of alcoholic paper wipes for routine hand cleansing: results of trials in two hospitals. J Hosp Infect 1986; 8: 268-274.
22. Kolari PJ, Ojajärvi J, Lauharanta J, Mäkelä P. Cleansing of hands with emulsion - a solution to skin problems of hospital staff? J Hosp Infect 1989; 13: 377-386.
23. Larson E. APIC guidelines for infection control practice: guideline for use of topical antimicrobial agents. Am J Infect Control 1988; 16: 253-266.
24. Larson E. Handwashing: it's essential - even when you wear gloves. Am J Nurs 1989; 89: 934-939.
25. Beck WC. Alcohol foam has a place in the clinical arena. AORNJ 1989; 50: 157-158.
26. Laufman H. Current use of skin wound cleansers and antiseptics. Am J Surg 1989; 157: 359-365.
27. Anon. ACORN Guidelines and Recommended Practices. Australian Confederation of Operating Room Nurses 1989.
28. Fisher RA, Yates F. Statistical Tables for Biological, Agricultural and Medical Research. 6th edn. Longman 1963: 86.
29. Hall R, Denton G, Bucknall RA. Use and evaluation of antiseptics for the treatment of intact and broken skin (wounds) in hospital. In: Collins CH, Allwood MC, Bloomfield SF, Fox A, Eds. Disinfectants: Their Use and Evaluation of Effectiveness. London: Academic Press 1981: 109-121.
30. Miles AA, Misra SA, Irwin JO. The estimation of the bactericidal power of the blood. J Hyg (Lond) 1938; 38: 733.
31. Larson EL, Butz AM, Gullette DL, Laughon BA. Alcohol for surgical scrubbing? Infect Control Hosp Epidemiol 1990; 11: 139-143.
32. Newman JL, Seitz JC. Intermittent use of antimicrobial hand gel for reducing soap-induced irritation of health care personnel. Am J Infect Control 1990; 18: 194-200.
33. Grove GL. Techniques for substantiating skin care product claims. In: Kligman AM, Leyden JJ, Eds. Safety and Efficacy of Topical Drugs and Cosmetics. New York: Grune and Stratton 1982: 157-175.
34. Norušis MJ/SPSS Inc. SPSS for Windows Advanced Statistics Release 6.0. Chicago: Marketing Department SPSS Inc. 1993: 37-40.
35. Aly R, Shirley C, Cunico B, Maibach HI. Effect of prolonged occlusion on the microbial flora, pH, carbon dioxide and transepidermal water loss on human skin. J Invest Dermatol 1978; 71: 378-381.
36. Price PB. New studies in surgical bacteriology and surgical technic with special reference to disinfection of the skin. JAMA 1938; 111: 1993-1996.
37. Lowbury EJL, Lilly HA. Use of 4% chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection. BMJ 1973; 1: 510-515.
38. Lilly HA, Lowbury EJL, Wilkins MD, Zaggy A. Delayed antimicrobial effects of skin disinfection by alcohol, J Hyg (Camb) 1979; 82: 497-500.
39. Aly R, Maibach HI. A comparison of the antimicrobial effect of 0.5% chlorhexidine (Hibistat) and 70% isopropyl alcohol on hands contaminated with Serratia marcescens. Clin Exp Dermatol 1980; 5: 197-201.
40. Larson EL, Eke PI, Laughon BE. Efficacy of alcohol-based hand rinses under frequent-use conditions. Antimicrob Agents Chemother 1986; 30: 542-544.
41. Lowbury EJL, Lilly HA, Ayliffe GAJ. Preoperative disinfection of surgeon's hands: use of alcoholic solutions and effects of gloves on skin flora. BMJ 1974; 4: 369-372.
42. Ayliffe GAJ, Babb JR, Davies JG, Lilly HA. Hand disinfection: a comparison of various agents in laboratory and ward studies. J Hosp Infect 1988; 11: 226-243.
43. Adams BG, Marrie TJ. Hand carriage of aerobic Gram-negative rods by healthcare personnel. J Hyg (Cam) 1982; 89: 23-31.