Alcohol-Based Surgical Hand Preparation: Translating Scientific Evidence Into Clinical Practice


Although alcohol-based surgical hand preparation offers potential advantages over the traditional surgical scrubbing technique, implementing it may be challenging due to resistance of surgeons in changing their practice. Gaspar, et al. (2018) aimed to implement alcohol-based surgical hand preparation in the hospital setting evaluating the impact of that on the quality and duration of the procedure, as well as on the prevention of surgical site infections.

A quasi-experimental study was conducted at a tertiary-care university hospital from April 1 to Nov. 1, 2017. Participants were cardiac and orthopedic surgical teams (n = 56) and patients operated by them (n = 231). Intervention consisted of making alcohol-based handrub available in the operating room, convincing and training surgical teams for using it, promoting direct observation of surgical hand preparation, and providing aggregated feedback on the quality of the preparation. The primary study outcome was the quality of the surgical hand preparation, inferred by the compliance with each one of the steps predicted in the World Health Organization (WHO) technique, evaluated through direct observation. Secondary study outcome was the patient’s individual probability of developing surgical site infection in both study periods. The researchers used the Wilcoxon for paired samples and McNemar’s test to assess the primary study outcome and build a logistic regression model to assess the secondary outcome.

The researchers observed 534 surgical hand preparation events. Among 33 participants with full data available for both study periods, we observed full compliance with all the steps predicted in the WHO technique in 0.03% (1/33) of them in the pre-intervention period and in 36.36% (12/33) of them in the intervention period (OR:12.0, 95% CI: 2. 4-59.2, p = 0.002). Compared to the pre-intervention period, the intervention reduced the duration of the preparation (4.8 min vs 2.7 min, respectively; p < 0.001). The individual risk of developing a surgical site infection did not significantly change between the pre-intervention and the intervention phase (Adjusted RR = 0.66; 95% CI 0. 16-2.70, p = 0.563).

The researchers say their results demonstrate that, when compared to the traditional surgical scrub, alcohol-based surgical hand preparation improves the quality and reduces the duration of the preparation, being at least equally effective for the prevention of surgical site infections.

Source: Reference: Gaspar GG, et al. Alcohol-based surgical hand preparation: translating scientific evidence into clinical practice. Antimicrobial Resistance & Infection Control. 2018;7:80

Related Videos
Association for Professionals in Infection Control and Epidemiology  (Image credit: APIC)
Patient Safety: Infection Control Today's Trending Topic for March
Infection Control Today® (ICT®) talks with John Kimsey, vice president of processing optimization and customer success for Steris.
Picture at AORN’s International Surgical Conference & Expo 2024
Rare Disease Month: An Infection Control Today® and Contagion® collaboration.
Lucy S. Witt, MD, investigates hospital bed's role in C difficile transmission, emphasizing room interactions and infection prevention
Chikungunya virus, 3D illustration. Emerging mosquito-borne RNA virus from Togaviridae family that can cause outbreaks of a debilitating arthritis-like disease   (Adobe Stock 126688070 by Dr Microbe)
An eye instrument holding an intraocular lens for cataract surgery. How to clean and sterilize it appropriately?   (Adobe Stock 417326809By Mohammed)
Ambassador Deborah Birx, , speaks with Infection Control Today about masks in schools and the newest variant.
Related Content