Surgical scrubbing with and without a brush in decreasing the number of germ colonies on hands: A Systematic review

Purpose@#This study aims to compare surgical scrubbing with and without a brush in decreasing the number of germ colonies on hands.@*Background@#Surgical scrubbing with and without a brush are currently popular worldwide. To date, the optimal method in decreasing the number of germ colonies on the hands is not known.@*Methods@#Systematic review of effectiveness was conducted. The databases and publisher websites included PubMed, Science Direct, Google Scholar, Wiley Online Library, Cochrane Library and recruitment studies published between 2009-2019. The risk of bias was assessed utilizing Cochrane Collaboration's tool.@*Results@#Included clinical studies consisting of five randomized controlled trials. The procedures and duration of surgical scrubbing on each study varied depending on the protocol as a reference. All clinical studies found no difference in the number of colonyforming units (CFU) on the hand between surgical scrubbing with and without a brush.@*Conclusions@#Scrubbing with and without a brush showed similar efficacy in terms of the number of germ colonies on the hands.

The Effect of Surgical Scrub in Orthopaedic Surgery / 대한정형외과학회잡지

PURPOSE: Two antiseptic solutions were investigated for their effect on bacterial growth inhibition. MATERIALS AND METHODS: A total of 38 patients were included in this study, who visited Daegu Catholic Medical Center from August 2, 2011 to September 2, 2011. Bacterial culture was performed at the pre-scrub, post-scrub, and postoperation; patients were divided into two groups according to use of povidone iodine (3.75%) and povidone iodine with Softa-Man(R) as antiseptic agents at the surgical. RESULTS: Comparison between the antiseptic solutions showed a significant difference for the presence of gram positive cocci (p=0.034), however, no difference was observed for the presence of gram positive bacilli (p=0.838). As the scrub time increased, the positive detection ratio of bacteria decreased (p=0.000), and decreased significantly at more than 120 seconds. However, positive detection ratio of bacteria increased significantly at more than 300 seconds in cases with povidone iodine only (p=0.014). Glove wearing time did not have a significant influence on the positive detection ratio of bacteria, and no significant difference was observed between the antiseptic solutions (p=0.143). CONCLUSION: Considering the positive detection ratio of bacteria when using povidone iodine only, the appropriate scrub time should be between 4 and 5 minutes. When using both antiseptics, at least 2 minutes of scrub time is needed.

Evaluation of a Waterless, Scrubless Chlorhexidine Gluconate/Ethanol Surgical Scrub and Povidone-Iodine for Antimicrobial Efficacy / 간호학회지

PURPOSE: The purpose of this study was to compare 1% chlorhexidine-gluconate/61% ethanol (CHG/Ethanol) emollient and 7.5% povidone-iodine (PVI) scrub for antimicrobial,residual effect, and skin condition. METHOD: CHG/Ethanol emollient hand hygiene was performed waterless, and brushless by operating doctors and nurses (N=20). PVI hand washing was performed with water and a brush (N=20) for 5 min. The subjects were asked to press their left hand in hand-shaped agar before a surgical scrub, immediately after a surgical scrub and after the operation. The amount of isolated microorganisms were calculated by counting the number of divided areas(1 X 1 cm, 160 cell) which were culture positive in the hand culture plate. The skin condition was evaluated. RESULT: The antimicrobial count of CHG/Ethanol emollient and PVI immediately post surgical scrub was 0.0 vs. 4.1 (p>.05), and after the operation was 0.1 vs. 37.8 (p>.05)respectively. The Residual effect of CHG/Ethanol emollient immediately post surgical scrub and after the operation were 0.0 vs. 0.1 (p>.05), and PVI were 4.1 vs. 37.8 (p>.05)respectively. The skin condition and satisfaction of CHG/Ethanol emollient was higher than PVI (p<.05). CONCLUSION: The antimicrobial effect between CHG/Ethanol emollient and PVI were the same. Considering skin condition, satisfaction and allergic reaction CHG/Ethanol emollient for surgical scrub is recommended in Korea.

Effects of Disinfection According to Durations of Surgical Hand Scrub and Type of Disinfectant / 기본간호학회지

PURPOSE: This study was done to identify the differences in effectiveness of disinfections for surgical hand scrubbing according to the duration of scrubbing and the type of disinfectant. METHOD: From June 30 to August 14, 2003, the data were collected from 30 surgical nurses and surgeons in one general hospital in P city, Korea. All participants washed their hands with two different disinfectants and four different scrubbing times, they placed both finger tips on a blood agar plate and using sterile cotton tips microbes were collected from their palms, nails and forearms. RESULTS: The first hypothesis of this study(with same disinfectant, there will be no difference in effect of disinfection in surgical hand scrub among four time groups) was supported. The second hypothesis of this study(with same duration of surgical hand scrub, there will be no difference in effect between two disinfectants) was also supported. CONCLUSION: There are no differences in effectiveness of disinfection for surgical hand scrubbing according to duration of the scrubbing and the type of disinfectant. So it is concluded that the effectiveness of disinfection depends more on the exactly how the scrubbing is done rather than the duration of scrubbing or the type of disinfectant.

A comparative study using two different agents and duration of scrubbing for disinfection of the skin

Reduction of skin bacteria on the hands of the surgeon and the rest of the operating team is widely believed to be of paramount importance. In this study we compared the efficacy of two currently available surgical scrub preparations, and the duration of scrubbing as a means of reducing bacterial flora of the hands before every operation using the fingertip culture technique in six different groups: those who will scrub for 3 and 5 minutes using chlorhexidine and povidone iodine, and those who will dip their hands for one minute using the two separate solutions. Bacteriologic studies were done using nutrient agar plates incubated prior to bacterial determination and colony counting derived from 3 separate occasions: before any washing of the hands; immediately after scrubbing for the prescribed period of time; and after 1 minute dipping with the assigned agents. It was found out that there is no significant difference between a 3 and a 5-minute scrub. Brief dipping of the hands permits adequate microbial reduction and chlorhexidine produced the greatest reduction against bacterial flora. (Author)