Efficacy of two distinct ethanol-based hand rubs for surgical hand disinfection -- a controlled trial according to prEN 12791.

BACKGROUND: Aim of the study was to determine the efficacy of two distinct ethanol-based hand rubs for surgical hand disinfection in a controlled cross-over trial according to prEN 12791.

METHODS: 20 subjects were included. Hands were washed for 1 min with soap. The bacterial prevalue was obtained by rubbing finger tips in TSB for 1 min. Then, each subject treated the hands with the reference procedure (n-propanol, 60% v/v) or the product (Sterillium Rub, based on 80% ethanol; Avagard, based on 61% ethanol and 1% chlorhexidine gluconate) which were all applied in 3 to 4 portions each of 3 ml for a total of 3 min. Bacterial postvalues (immediate effect) were taken from one hand, the other hand was gloved for 3 h. After gloves were taken off the second postvalue was taken for the assessment of a sustained effect.

RESULTS: Bacterial pre-values were between 4.38 +/- 0.66 and 4.46 +/- 0.71. Sterillium Rub achieved the required immediate (mean log10-reduction of 2.59 +/- 1.19) and sustained effect (1.73 +/- 1.08) compared with the reference treatment (immediate effect: 2.58 +/- 1.16; sustained effect: 1.67 +/- 0.96). Avagard, however, did not achieve the required immediate (1.82 +/- 1.40) and sustained effect (1.41 +/- 1.08) in comparison to the reference disinfection (immediate effect: 2.98 +/- 0.90; sustained effect: 2.56 +/- 1.17; p < 0.01; Wilcoxon test).

CONCLUSION: Based on our data, Sterillium Rub can be regarded to be effective for surgical hand disinfection, but Avagard can not. The addition of 1% chlorhexidine gluconate to 61% ethanol (w/w) did not outweigh an ethanol concentration of 80% (w/w).