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Hand washing rituals in trauma theatre: clean or dirty?

Lookup NU author(s): Lynne Longstaff


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INTRODUCTION The aim of this study was to investigate the degree of contamination of surgeon's hand owing use of chlorhexidine gluconate or alcohol gel as disinfectants. MATERIALS AND METHODS In this prospective, randomised trial orthopaedic surgeons wee at locates to one of two differential hand washing protocols using a randomisation table. the hand-washing protocol dictated that all surgeons should wash for 5 min with chlorhexidine for their first case. Thereafter, the surgeon was randomised to wash for 3 min with either alcohol gel or chlorhexidine. At the end of each procedure, the gloves of each surgeon were carefully removed and the fingertips from each hand were placed on an agar plate. The number of bacterial colonies present after 24 h and 48 h of incubation were recorded for each agar plate by a microbiologist blinded to the washing protocol used. RESULTs Overall, 41 procedures and 82 episodes of hand washings were included in the study. Two episodes were discarded due to contamination the the time of glove removal. Four hands (8%) were contaminated in the chlorhexidine group compared to 19 (34%) in the alcohol group. Fisher's exact test conformed a significantly higher risk of contamination using alcohol gel compared to chlorhexidine (P = 0.002). In addition, the average bacterial colony count was substantially higher in the alcohol group (20 colony forming units) compared to the chlorhexidine group (5 colony forming units). There was no relationship between the duration of surgery and the degree of contamination (P = 1.12). CONCLUSIONS Alcohol gel disinfectant is not a suitable alternative to chlorhexidine when hand washing before surgery. This study has identified a higher risk of bacterial contamination of surgeons' hands washed with alcohol. This may lead to higher levels of postoperative infection in the event of glove peroration.

Publication metadata

Author(s): Hajipour L, Longstaff L, Cleeve V, Brewster N, Bint D, Henman P

Publication type: Article

Publication status: Published

Journal: Annals of the Royal College of Surgeons of England

Year: 2006

Volume: 88

Issue: 1

Pages: 13-15

ISSN (print): 0035-8843

ISSN (electronic): 1478-7083

Publisher: The Royal College of Surgeons of England


DOI: 10.1308/003588406X83032


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