EJMS

Abstract

Background: The surgical team members use different methods of surgical hand antisepsis with the aim of reducing surgical site infections. Aim: This study aimed to investigate the effectiveness of povidone iodine hand scrubbing versus alcohol and avagard hand rubbing on reduction of microbial count among surgical team members in a Saudi Hospital. Methods: The outcome measure is the number of Colony Forming Units (CFUs) cultured from 10-digit fingertip imprints on agar plates. Seventy two volunteers underwent 3 hand preparation protocols; Protocol (A) included 3 minutes of traditional scrub by PVP-I, protocol (B) involved 3 minutes of hand rubbing, until dry with ethyl alcohol 70%. Protocol (C) included 3 minutes of hand rubbing, until dry with Avagard. Three sets of fingertip imprints obtained for each group; before rubbing/scrubbing (R/Sc.), immediately after R/Sc., and after glove removal (GR) ie; after 3 hours. Results: Results expressed as the number of CFUs per hand by the use of Log10 RF. No significant difference in baseline hand bacterial load was found before and immediately after hand- R/Sc. procedures among the three groups, while there a significant statistical difference in microbial count after GR (p value = 0.01) and microbial count was lesser by the use of avagard than by the use of other solutions after GR. There was a significant statistical relation between participant's occupation and Count of CFUs (p value = 0.05) and the count found to be decreased among nurses after GR. However, there was no significant statistical difference between participant's years of experience and counts of CFUs. Results revealed a significant statistical correlation between performance of rubbing/scrubbing and count of CFUs among the three groups; immediately post R/Sc. and after GR. Conclusion and recommendations: Surgical hand rub using avagard was significantly more effective in reducing skin colony counts compared to ethyl alcohol 70% and povidone iodine 7.5%. We recommend that avagard hand rubs could be used as a potent hand antisepsis in the operating theatre.