A microbiological in-use comparison of surgical hand-washing agents.

Seven different surgical hand-scrub agents (one triclosan compound, two hexachlorophene compounds, and four iodophors) were evaluated under in-use conditions by five persons for efficacy in degerming the hands and forearms prior to performing a total of 215 total hip arthroplasties. With all of the compounds tested there was a significant reduction (p less than or equal to 0.001) of indigenous skin microflora from prescrub levels at both the post-scrub and postoperative points. The two hexachlorophene compounds in general revealed a bacteriostatic effect whereas the triclosan compound and the four iodophors did not. A hexachlorophene compound applied as a foam demonstrated excellent bacteriocidal and bacteriostatic action, was less time-consuming and easier to use than compounds applied as scrubs, and did not alter a low (0.47 per cent) in-use infection rate over a period of three years.