Effectiveness of Surgical Hand Antisepsis Using Chlorhexidine Digluconate and Parachlorometaxylenol Hand Scrub
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Effectiveness of Surgical Hand Antisepsis Using Chlorhexidine Digluconate and Parachlorometaxylenol Hand ScrubAuthor(s)
Date
2018-10Citation
Vallejo, Ricardo Becerro de Bengoa PhD, DPM, DHLa; Fernandez, David Sevillano PhDa; Cervera, Luis Alou PhDb; Aragón, Laura Martín PhDa; Iglesias, Marta Elena Losa PhDc,∗; Yurrita, Luis Rodolfo Collado MD, PhDa; Lopez, Daniel Lopezd Effectiveness of surgical hand antisepsis using chlorhexidine digluconate and parachlorometaxylenol hand scrub, Medicine: October 2018 - Volume 97 - Issue 42 - p e12831 doi: 10.1097/MD.0000000000012831
Abstract
[Abstract] Background:
Chlorhexidine and parachlorometaxylenol (PCMX) are antiseptics recommended for surgical hand antisepsis. To our knowledge, PCMX has not been evaluated for bactericidal efficacy “in vivo.
Methods:
We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). We assessed bacterial load after a prewash with soft soap, immediately after application of an antiseptic, and 3 hours after application and wearing of sterile, powder-free gloves. Our procedures followed those specified by European Norm (EN) 12791 for evaluating surgical hand antiseptics and using cotton swab for fingertips and fingernails.
Results:
Chlorhexidine digluconate 4% and PCMX 3% did not decrease bacterial load on the hands. The bactericidal performances of chlorhexidine digluconate 4% and PCMX 3% did not differ significantly. Chlorhexidine digluconate 4% and PCMX 3% increased bacterial load on the fingertips after participants had worn gloves for 3 hours. Fingernails had greater bacterial loads than skin on the fingertips.
Conclusions:
Chlorhexidine digluconate 4% and PCMX 3% had similar bactericidal efficacy, but they failed to meet the EN 12791 efficacy standard. Fingernails should be a particular focus of antisepsis in preparation for surgery.
The trial was registered at ClinicalTrials.gov (ID: NCT02500758).
Keywords
Antisepsis
Antisepsia
Randomized controlled trial
Ensayo controlado aleatorizado
Surgical site infection
Infección del área quirúrgica
Antisepsia
Randomized controlled trial
Ensayo controlado aleatorizado
Surgical site infection
Infección del área quirúrgica
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Atribución-NoComercial 4.0 Internacional