Larson E L, Butz A M, Gullette D L, Laughon B A
Johns Hopkins University School of Nursing, Baltimore, MD 21205.
Infect Control Hosp Epidemiol. 1990 Mar;11(3):139-43. doi: 10.1086/646137.
To test the effects of four surgical scrub products on colonizing hand flora, 60 healthy adult volunteers were assigned by block randomization (12 subjects per group) to use one of the following formulations: 70% ethyl alcohol with 0.5% chlorhexidine gluconate (ALC); a liquid detergent base containing 1% triclosan (TRI); a liquid detergent base containing 4% chlorhexidine gluconate (CHG); a liquid detergent base containing 7.5% povidone-iodine (PI); or a nonantimicrobial liquid soap (control). Using standard protocol, subjects performed a surgical scrub daily for five consecutive days. Hand cultures were obtained at baseline and on test days 1 and 5 immediately after the scrub and following four hours of gloving. After the first and last scrubs, ALC, CHG and PI resulted in significant reductions in colonizing flora when compared to the control. Additionally, by day 5 ALC was associated with an almost 3-log reduction as compared to an approximate 1.5-log reduction for CHG and PI and less than a 1-log reduction of TRI and the control (p = .009). After four hours of gloving on both days 1 and 5, microbial counts on hands of subjects using ALC, TRI and CHG were significantly lower than counts for the control (p less than .001), whereas there was no significant difference in counts between the PI and control groups (p = .41). Skin assessment by study subjects rated products from least to most harsh as follows: control, TRI, CHG, ALC and PI p = .00001). It was concluded that ALC could be an efficacious and acceptable alternative for surgical scrubbing.
为测试四种外科洗手产品对手部定植菌群的影响，通过区组随机化将60名健康成年志愿者（每组12名受试者）分配使用以下配方之一：含0.5%葡萄糖酸氯己定的70%乙醇（ALC）；含1%三氯生的液体洗涤剂基质（TRI）；含4%葡萄糖酸氯己定的液体洗涤剂基质（CHG）；含7.5%聚维酮碘的液体洗涤剂基质（PI）；或非抗菌液体肥皂（对照）。按照标准方案，受试者连续五天每天进行一次外科洗手。在基线、测试第1天和第5天洗手后及戴手套4小时后采集手部培养物。与对照相比，首次和末次洗手后，ALC、CHG和PI使定植菌群显著减少。此外，到第5天，ALC导致的菌群减少近3个对数，而CHG和PI约为1.5个对数，TRI和对照则不到1个对数（p = 0.009）。在第1天和第5天戴手套4小时后，使用ALC、TRI和CHG的受试者手上的微生物计数显著低于对照组（p小于0.001），而PI组和对照组之间的计数无显著差异（p = 0.41）。研究受试者对皮肤的评估将产品从最温和到最刺激进行排序如下：对照、TRI、CHG、ALC和PI（p = 0.00001）。得出的结论是，ALC可能是外科洗手的一种有效且可接受的替代方法。
