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Eur J Clin Microbiol Infect Dis (2009) 28:13571362 DOI 10.1007/s10096-009-0792-7
ARTICLE
A 1-minute hand wash does not impair the efficacyof a propanol-based hand rub in two consecutive surgical hand disinfection procedures
G. Kampf & C. Ostermeyer
Received: 13 March 2009 /Accepted: 15 July 2009 /Published online: 11 August 2009 # Springer-Verlag 2009
Abstract We studied the effect of a 1-min hand wash on the bacterial hand flora in two consecutive surgical hand disinfection procedures. A propanol-based hand rub (PBHR; Sterillium) and n-propanol (60%, v/v) were tested in a Latin-square design according to EN 12791 in four variations. The reference alcohol was always applied for 3 min after a 1-min hand wash (variation 1). The PBHR was applied for 1.5 min (first application) or 0.5 min (second application). Variation 2 included a 1-min hand wash before both applications, variation 3 included the hand wash before application 1, in variation 4 hands were not washed at all before application. Pre- and post-values were obtained according to EN 12791. The reference disinfection reduced bacteria by 2.99 log10 (immediate efficacy) and 2.22 log10 after 3 h. The second reference disinfection reduced bacteria by 0.95 log10 (immediate efficacy) and 0.68 log10 after 3 h. The PBHR always yielded an equivalent reduction with and without a preceding hand wash (p>0.05; Friedman test). A 1-min
hand wash before application of the PBHR did not significantly change its efficacy for surgical hand disinfection in two consecutive surgical procedures of 3 h.
Introduction
Alcohol-based hand rubs are often recommended and widely used for surgical hand disinfection in many countries [1, 2]. They are considered to have better antimicrobial efficacy and dermal tolerance, which are regarded as two clear advantages in comparison to antimicrobial soaps [36]. In clinical practice many surgeons wash their hands for 1 min before the hand rub is applied because it has been tradition to do so and it has been recommended for decades [7]. Recent data indicate that the 1-min hand wash has various disadvantages such as a prolonged increase in skin hydration for approximately 10 min [8], a variable impairment of the efficacy of the alcohol-based hand rub [9, 10], and an additional potential for skin irritation [5, 11]. Unless hands are visibly soiled there is no clear advantage...