Journal of Nippon Medical School: Vol.71 No.3 page.190

Journal of Nippon Medical School

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ArticleTitle A New Surgical Handwashing and Hand Antisepsis From Scrubbing to Rubbing

AuthorList Kiyonori Furukawa¹, Rho Ogawa², Yoshihiro Norose³ and Takashi Tajiri¹

Affiliation ¹Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
²Department of Anesthesiology, Nippon Medical School
³Department of Microbiology and Immunology, Nippon Medical School

Language JA

Volume 71

Issue 3

Year 2004

Page 190-197

Received January 9, 2004

Accepted February 9, 2004

Keywords surgical handwashing, surgical hand antisepsis, glove-juice method, surgical hand rubbing, alcohol-based hand rubbing

Abstract
In 2002, the Centers for Disease Control and Prevention (CDC) published guidelines for surgical handwashing and hand antisepsis on the Internet. According to these guidelines, we revised our surgical handwashing method from scrubbing with brushes to rubbing with antiseptic. The new method consists of scrubbing around the nails with brushes and rubbing the hands and arms with antiseptic from the elbow to the antebrachium. A total of 182 surgeons and operating-room nurses participated in the current study. Bacterial contamination was investigated using the glove-juice method.

The new surgical handwashing method is simple, and requires only a short time to perform (2 minutes 50 seconds). The bacterial examination confirmed that rubbing the hands with antiseptic was significantly more effective than scrubbing with brushes. In terms of sterilization or prolonged effects, 4% chlor-hexidine gluconate (CHG) was superior to 7.5% povidone-iodine (PVI) throughout a 3-hour period after hand antisepsis. Although bacterial counts were increased 3 hours after the beginning of surgery, additional hand rubbing with 0.2% chlorhexidine-83% ethanol (Hibisoft^TM) was effective in suppressing the number of bacteria. Hibisoft^TM successfully prolonged sterilization for more than 3 hours.

For long surgical procedures, CHG should be used as an antiseptic and gloves should be changed every 3 hours, alcohol-based hand rubbing should also be performed 3 hours after the initial handwashing. This new technique will be included in the OSCE curriculum to ensure its standardization. Moreover, in-depth education regarding central operating-room practices is desired.

Correspondence to Kiyonori Furukawa, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
seiken-f@nms.ac.jp

ArticleTitle	A New Surgical Handwashing and Hand Antisepsis From Scrubbing to Rubbing
AuthorList	Kiyonori Furukawa¹, Rho Ogawa², Yoshihiro Norose³ and Takashi Tajiri¹
Affiliation	¹Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine ²Department of Anesthesiology, Nippon Medical School ³Department of Microbiology and Immunology, Nippon Medical School
Language	JA
Volume	71
Issue	3
Year	2004
Page	190-197
Received	January 9, 2004
Accepted	February 9, 2004
Keywords	surgical handwashing, surgical hand antisepsis, glove-juice method, surgical hand rubbing, alcohol-based hand rubbing
Abstract	In 2002, the Centers for Disease Control and Prevention (CDC) published guidelines for surgical handwashing and hand antisepsis on the Internet. According to these guidelines, we revised our surgical handwashing method from scrubbing with brushes to rubbing with antiseptic. The new method consists of scrubbing around the nails with brushes and rubbing the hands and arms with antiseptic from the elbow to the antebrachium. A total of 182 surgeons and operating-room nurses participated in the current study. Bacterial contamination was investigated using the glove-juice method. The new surgical handwashing method is simple, and requires only a short time to perform (2 minutes 50 seconds). The bacterial examination confirmed that rubbing the hands with antiseptic was significantly more effective than scrubbing with brushes. In terms of sterilization or prolonged effects, 4% chlor-hexidine gluconate (CHG) was superior to 7.5% povidone-iodine (PVI) throughout a 3-hour period after hand antisepsis. Although bacterial counts were increased 3 hours after the beginning of surgery, additional hand rubbing with 0.2% chlorhexidine-83% ethanol (Hibisoft^TM) was effective in suppressing the number of bacteria. Hibisoft^TM successfully prolonged sterilization for more than 3 hours. For long surgical procedures, CHG should be used as an antiseptic and gloves should be changed every 3 hours, alcohol-based hand rubbing should also be performed 3 hours after the initial handwashing. This new technique will be included in the OSCE curriculum to ensure its standardization. Moreover, in-depth education regarding central operating-room practices is desired.
Correspondence to	Kiyonori Furukawa, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan seiken-f@nms.ac.jp