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- Title
Alcohol-based hand-rub versus traditional surgical scrub and the risk of surgical site infection: a randomized controlled equivalent trial.
- Authors
Al-Naami, Mohammed Y.; Anjum, Muhammad N.; Afzal, Muhammed F.; Al-Yami, Mohammad S.; Al-Qahtani, Saad M.; Al-Dohayan, Abdullah D.; El-Tinay, Omar Farouk Y.; Karim, Amal A. Al-Abdul; Khairy, Gamal A.; Al-Saif, Abdulaziz A.; Zubaidi, Ahamd M.; Al-Obaid, Omar A.; Al-Saif, Faisal A.
- Abstract
Preoperative surgeons' hands antisepsis has evolved over the last few centuries leading to important reductions in surgical site infection (SSI) rate, morbidity and mortality, and duration of hospital stay. Recently, new alcohol gel preparations have been advocated as a good alternative to antiseptic hand washing for the control of nosocomial infections among health care workers and patients. This has been attributed to better compliance and the efficient antibacterial activity of alcohol preparations. However, these preparations have not been examined enough in comparison to the traditional preoperative surgical scrub for surgeons' hands disinfection. Objective: To examine the effectiveness of preoperative hand disinfection using alcohol gel preparation in comparison to traditional surgical scrub solutions to prevent SSI, and their effect on surgeons' skin. Setting and Methods: This trial was conducted in the Division of General Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia. The study period was for nine months from October 1, 2007 to June 30, 2008. A total of 500 patients, who underwent different clean and clean contaminated general surgical procedures, were randomized as regards to traditional surgical scrub and alcohol hand-rub of surgeons' hands preoperatively. The primary outcome measure was the incidence of SSI in each group; the secondary outcome was surgeons' skin reactions. Patients were followed up to one month from discharge. Data were analyzed using the SPSS version. Results: Group One involved 228 patients who underwent surgical procedures where the traditional surgeons' hand scrub was used (mean age ±SD=37.94±14.34, 65 males and 163 females). Group Two involved 272 patients who underwent procedures where an alcohol hand-rub was used (mean age ±SD=39.16±14.55, 97 males and 175 females). SSIs were reported in 12(5.3%) cases of Group 1 and in 8(2.94%) cases of Group 2 (p>0.05, odd ratio=1.833, and confidence limit= 0.683-5.007). Total skin reactions were reported by 40 (17.5%) surgeons in Group1 and by 31 (11.4%) in Group 2 (p>0.05, odd ratio=1.65408, and confidence interval=0.96826-2.83007). Most surgeons (64%) preferred using the alcohol handrub over the traditional surgical scrub. Conclusions: Preoperative alcohol hand-rub preparations are as good as traditional surgical scrub in reducing SSI and not affecting surgeons' skin tolerance. The alcohol hand-rub, however, was easier to use and preferred by surgeons.
- Subjects
SAUDI Arabia; MEDICAL research; SURGICAL scrub; SURGICAL site; INFECTION risk factors; RANDOMIZED controlled trials; SURGEONS; DISEASES; MORTALITY; SANITATION
- Publication
EWMA Journal, 2009, Vol 9, Issue 3, p5
- ISSN
1609-2759
- Publication type
Article