Scrubbing technique and surgical site infections: an analysis of 14,200 neurosurgical cases

Clinical Issues-July 2022

Surgical hand antisepsis recommendations Key words: surgical hand scrub, alcohol-based hand rub, dry scrub, wet scrub, antimicrobial. Surgical hand rub preparation Key words: surgical hand antiseptic, hand wash, nail pick, hand hygiene, scrub personnel. Use of a closing tray Key words: clean-contaminated, isolation technique, gastrointestinal tract, wound class, wound closure. Hemostatic agent classification Key words: Class III medical devices, absorbable hemostatic agents, product classification, medical specialty panels, Code of Federal Regulations (CFR).

What is new with hand hygiene?

PURPOSE OF REVIEW

Healthcare-associated infections (HAIs) challenge healthcare systems worldwide. As healthcare workers' hands are considered the main vector for transmission of pathogens, effective hand hygiene is the single most important action to prevent HAIs. We sought to highlight new developments and advances in hand hygiene.

RECENT FINDINGS

Hand hygiene compliance averages at 38%. A sustained increase of compliance with a subsequent decrease of HAIs may be achieved by national, systematic and rigorous education, and auditing programs. Periodically deployed self-operating hand hygiene surveillance systems coupled with personalized reminders could facilitate such efforts. Alcohol-based hand-rub (ABHR) solutions remain the hand hygiene gold standard, but are modified in texture and composition to better meet healthcare workers' preferences. Modifications of the hand hygiene procedure have been proposed targeting both time and technique of hand rub application. Reducing rub-time from 30 to 15 s and simplifying the technique to consist of three rather than six steps yielded encouraging results in terms of microbiological efficacy and higher compliance.

SUMMARY

Implementation and promotion of compliance are the major concerns of today's research on hand hygiene. Developments towards better surveillance and systematic education, improved ABHR formulation and streamlining of hand hygiene actions are paving the way ahead.