Comparison of Two Surgical Hand Antiseptic Techniques: Hand Rubbing and Hand Washing With Alcohol-Based Agent and 7.5% Povidone Iodine

Hand disinfection is a major part of infection control during a surgical procedure. In contrast to developed countries, where the use of alcohol-based solutions (ABS) is routine, the usual practice in Iran is hand scrubbing using Povidone Iodine Solution (PVI). Most researchers have concluded that ABS might be superior to PVI, but others have found no differences. In this study the disinfection efficacy of ABS was compared to PVI.
Thirty-one volunteers including surgeons and operating room nurses (OR-nurses) participated in this cross over design study. For one week they used ABS and the next week they used PVI for pre-surgical hand disinfection. Samples were obtained from the hands of all participants before, immediately after and two hours after hand washing. The bacterial contamination rate was evaluated by a microbiologist.
Our results demonstrated that ABS led to significantly lower mean Colony Forming Units (CFU) immediately after hand disinfection, but no significant differences were found between the two groups after two hours. Also, alcohol-based solution revealed a significantly higher logarithmic reduction factor (RF) of skin flora as an instantaneous effect. Both solutions were effective against Staphylococcus aureus, but the minimum reduction rate was in eliminating the Bacillus group.
In conclusion, ABS can be promoted as the best choice for surgical hand disinfection solution amongst emergency situations, in that it has a time saving character and better instantaneous effect on bacterial skin flora reduction.