Nishimura Chieko
Operating Suite, Shinshu University Hospital, Nagano 390-8621, Japan.
Dermatology. 2006;212 Suppl 1:21-5. doi: 10.1159/000089195.
Scrubbing of the hands and forearms with a brush and antiseptic agents has been the standard for surgical practice. However, it has been increasingly recognized that brush scrubbing may provoke side effects and that an alcohol-based hand antiseptic used in conjunction with a scrub agent enhances the effectiveness. In this study, two types of alcohol-based agents were used after a povidone-iodine (PVP-I) scrub and compared for their effectiveness.
The study was conducted as a crossover trial with 20 volunteers. After hand rubbing with PVP-I, either PVP-I-ethanol rubbing or chlorhexidine gluconate-ethanol (CHG-ethanol) rubbing was used for surgical hand cleansing. Samples were collected by the modified glove juice method to count bacteria on hands.
In both groups, the bacterial count was significantly reduced after handwashing (p < 0.001), and the reduction was still significant after 2 h (p < 0.001 for PVP-I-ethanol and p < 0.002 for CHG-ethanol). The log(10) reduction factor (RF) in the PVP-I-ethanol group was significantly higher than that in the CHG-ethanol group immediately after handwashing (p < 0.001) but significantly lowered after 2 h (p < 0.01) to the level similar to that of CHG-ethanol. Although RF was lower in the CHG-ethanol group immediately after and 2 h after handwashing compared to the PVP-I-ethanol group, it did not decrease with time.
Brushless surgical scrubbing with PVP-I-ethanol or CHG-ethanol in conjunction with PVP-I showed antiseptic effects immediately after and 2 h after handwashing. RF immediately after handwashing was significantly higher with PVP-I-ethanol compared to CHG-ethanol, but it was similar in both groups after 2 h. These results suggest that when used in combination with a PVP-I scrub, an alcohol-based hand antiseptic containing the same active agent (PVP-I in this study) has a powerful antiseptic effect; however, when it contains different antiseptic agents (i.e. CHG in this study), it should be selected carefully based on its antiseptic property.
使用刷子和消毒剂对手部及前臂进行刷洗一直是外科手术操作的标准。然而，人们越来越认识到刷手可能会引发副作用，并且与擦洗剂联合使用的酒精基手部消毒剂可提高有效性。在本研究中，在聚维酮碘（PVP-I）擦洗后使用了两种类型的酒精基制剂，并比较了它们的有效性。
该研究作为一项交叉试验，有20名志愿者参与。在用PVP-I擦手后，使用PVP-I-乙醇擦手或葡萄糖酸洗必泰-乙醇（CHG-乙醇）擦手进行外科洗手。通过改良手套液法采集样本以计数手上的细菌。
两组洗手后细菌计数均显著降低（p < 0.001），2小时后降低仍显著（PVP-I-乙醇组p < 0.001，CHG-乙醇组p < 0.002）。洗手后立即，PVP-I-乙醇组的对数（1０）减少因子（RF）显著高于CHG-乙醇组（p < 0.001），但2小时后显著降低（p < 0.01）至与CHG-乙醇组相似的水平。尽管与PVP-I-乙醇组相比，CHG-乙醇组洗手后立即和2小时后的RF较低，但它并未随时间降低。
PVP-I-乙醇或CHG-乙醇与PVP-I联合进行免刷外科洗手在洗手后立即和2小时后均显示出抗菌效果。与CHG-乙醇相比，PVP-I-乙醇洗手后立即的RF显著更高，但2小时后两组相似。这些结果表明，当与PVP-I擦洗联合使用时，含有相同活性剂（本研究中的PVP-I）的酒精基手部消毒剂具有强大的抗菌效果；然而，当它含有不同的抗菌剂（即本研究中的CHG）时，应根据其抗菌性能仔细选择。
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