Hand disinfection surgical

Tests have been developed that test different products for their effectiveness as a healthcare personnel handwash (327) evaluate hand disinfectants for use in surgery (333) determine the effectiveness of a surgical hand scmb, ie, the glove juice test (311,329) evaluate antiseptics for the oral cavity to be used in mouthwashes (334,335) and test antiseptics for the periurethral area and appHcation to catheters (336,337). A method used for a test comparing four antiseptic products was adopted as recommended practice by the Association of Practitioners of Infection Control (338). 

Surgical hand disinfection. This term refers to the pre-operative disinfeetion of surgeons hands, with the aim of preventing surgieal wound infection. The most important criteria associated with surgical hand disinfection are ... 

The principle of tests evaluating the efficacy of surgical hand disinfectants is to sample the resident flora of the hands before and after surgical hand disinfection. 

Hygienic and surgical hand disinfection The former is required after a suspected contamination, the latter before surgical procedures. Alcohols, mixtures of alcohols and phenols, cationic surfactants, or acids are available for this purpose. Admixture of other agents prolongs duration of action and reduces flammability. 

The application of povidone-iodine formulations cannot be recommended for surgical hand disinfection, since active iodine-free formulations are available. 

V Hingst, I luditzki, P Heeg, H-O Sonntag. Evaluation of the efficacy of surgical hand disinfection following a reduced application time of 3 instead of 5 minutes. J Hosp Infect 20 79-86, 1992. 

Ayliffe GAJ, Babb JR, Davies JG, and Lilly HA Hand disinfection a comparison of various agents in laboratory and ward studies. J Hosp Infect 11 226-243, 1987. Engelsher HJ. A new surgical scrub brush. Am J Surg 112 964-966, 1966. 

H Reber, M Muntener, K Neck, U Lips. Test methods for surgical hand disinfection (author s transl). Zentralbl Bakteriol (Orig B) 160(6) 601-627, 1975. 

Aseptic techniques are used to avoid the possibility of infection of the animals or ceU cultures. These include the preparation of the vaccines and spleens under aseptic conditions in a class 100 clean room equipped with a laminar airfiow hood, sterilization of instruments, and treatment of work surfaces with disinfectant before and after use, washing of the investigator s hands with an antiseptic surgical scrub preparation, and wearing of sterile gloves, face mask, and eyeglasses. 

It is easier and more precise to hold the phenol-soaked cot-ton-tipped applicator with a bare, ungloved hand. It is therefore imperative for the doctor to disinfect his hands surgically to avoid infecting the patient s skin. The assistant who cuts the occlusive dressing and helps the doctor put them in place should also disinfect his hands in the same way, for the same reasons. 

The phenol solution is rolled " onto the skin with a cotton bud soaked in the product. If the doctor makes the applicator himself, he should check that his hands are sterile beforehand. It is difficult to make this rolling movement with gloved hands, as the glove can wind around the applicator and make application awkward, or even dangerous. Only the left hand should be gloved, and the right hand should be surgically disinfected and not come into contact unnecessarily with the skin. 

Disinfectant 30 to 40 drops per 1 quart (1 1) water. Use to clean hands, surgical instruments, rooms, linens. 

The sequential use of a chlorhexidine gluconate-containing detergent followed by an alcoholic disinfectant reduced the release of resident skin bacteria significantly better than did a sequence of unmedicated soap and alcohol used for the same periods. Paulson compared five surgical hand-scrub preparations (4% CHG brush, 2% CHG solution, povidone-iodine brush, parachlorometaxylenol brush, and alcohol-impregnated brush) [ 14]. Only the CHG products demonstrated antimicrobial effectiveness in all three parameters (immediate, persistent, and residual). A comparison also was made between a 5-minute povidone-iodine scrub and a 1 -minute povidone-iodine scrub, followed by alcohol foam [15]. The total number... 

Although alcohols, as topical skin disinfectants, provide excellent immediate antimicrobial activity, they show little persistent activity. Once dried on the skin surfaces, antimicrobial effects of an alcohol have ended. Hence, their value as surgical hand scrub formulations and preoperative skin preparations where... 

Fliigge introduced the distinction between the surgical and the hygienic disinfection of hands. 

Products used for the hand and skin disinfection ought to increase their bactericidal (vegetative phases), fungicidal, and virucidal efficacies. They should deliver their effects more rapidly, and they should exert no toxic effects on the skin. Disinfectant solutions used for the hygienic handrub mainly consist of alcohols (II, 1.), halogens (II, 21.2.), phenolics (II, 7.), or PVP-iodine (II, 21.2.12.), and are frequently combined with other ingredients. Products used for the surgical handrub mainly consist of alcohols, such as ethanol 80%, isopropanol 70%, n-propanol 60%i, or mixtures of those. 

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