Effectiveness of surgical hand scrub solutions

Abstract

A prospective randomized study of three popular hand scrub solutions was carried out to determine the effectiveness of antisepsis. The 3-minute scrub and 'no brush' hand rub techniques were also evaluated. G-11 hexachlorophene was found to be inappropriate as a surgical scrub due to its failure to decontaminate during the hand scrubbing and storage in its own dispenser in the operating room. Chlorhexidine 4% (Hibiscrub) and povidone-iodine 7.5% (Betadine scrub) were both equally effective during storage in dispensers. Chlorhexidine was more effective than povidone-iodine both during a straight 3-minute scrub (p=0.0007) and during a 3-minute scrub following a 3-minute hand rub (p=0.0051). The 3-minute hand rub 'no brush' technique, in spite of claims of adequate decontamination, reduced bacterial flora by only 84% in this study. The use of the 3-minute hand scrub significantly reduced the hand bacterial flora (p=0.00154) and seemed to be a better technique. Our study did not support the use of the two consecutive 3-minute scrub technique.