Surgical hand-washing

Abstract

Pre-operative hand-washing is essential for the reduction of surgical site infection (SSI) rate. This article aims to review the current literature regarding the issues on: (i) the duration of washing; (ii) the use of the brush; and (iii) the reagents used. Based on current evidence, preoperative hand-washing for 10 min is not recommended and 2-5 min is adequate. There is no evidence supporting the use of the brush, and washing without the brush may confer further advantages of reducing skin irritation and delayed colonization. The newly developed aqueous alcoholic solutions (AAS) are equally effective as conventional reagents such as chlorhexidine gluconate and povidone-iodine in preventing SSI. Aqueous alcoholic solutions have the advantage of better user compliance and causing fewer occupational hazards. The author concluded that a 1 min non-antiseptic hand-wash, followed by thorough rubbing with AAS until dry and without brushing is a safe and effective alternative to the conventional scrubbing technique.