When performing surgical procedures, a work environment that is as clean as possible is essential to stopping postoperative infections. For a long time, doctors, surgeons, and nurses have scrubbed their hands with an antimicrobial cleanser and water before surgical procedures, often many times throughout the day. The disadvantage of frequently washing hands is that it requires much time and wastes water.
Additionally, it frequently causes the skin to become irritated and inflamed in the hospital staff. The best method is hand washing during surgery using alcohol-based hand cleaners. This method allows staff to wash their hands only before the start of their surgical day or if their hands are dirty. In this article, we discuss the advantages of disinfection over hand washing.
From hand washing to hand disinfection
In recent years, however, a growing number of facilities are avoiding these hygiene methods for their hands and opting not to use soaps that contain chlorine (“scrub”). Instead, they’re opting for alcohol-based surgical hand-disinfection techniques (“rub”) that make use of hand disinfectants with no chlorhexidine. There are a variety of reasons behind this. Before examining the pros and drawbacks of these techniques, let’s look at how “rub” and “scrub” differ.
Rub Vs. Scrub: What’s the difference?
As we consider doctors getting ready for surgery, the first image usually is of nurses and surgeons carefully washing their forearms and hands throughout the day and then intensely “scrubbing” them. This is known as the “scrub” method, which uses chlorhexidine-based antimicrobial soaps. The average time for this process is 5 to 6 minutes long.
Utilizing”rub” or the “rub” method, surgeons, nurses, and doctors do not wash their hands for more than a minute before each procedure. Instead, they disinfect their hands by using alcohol-based hand disinfectants. In this situation, medical professionals only clean their hands before the beginning of the work day or when their hands appear filthy. Before performing any procedure, personnel must follow the following steps to wash their fingers and hands.
The removal of all jewelry (including wedding bands) and watches from your hands and forearms.
The disinfectant dispenser is activated by turning the lever, bending the elbow, and wetting both forearms and hands with enough hand disinfectant. The forearms and hands are thoroughly rubbed and kept in contact for the entire duration, which is 1.5 minutes.
Repeat the process to ensure that all the areas of the forearms and hands are completely disinfected.
Before putting on gloves, the disinfectant needs to dry completely.
Compared to hand washing with antimicrobials, alcohol-based disinfection before cleaning can bring many advantages for staff and facilities. Let’s examine them.
Numerous studies have proven the fact that regular usage of soaps that contain antimicrobials can result in allergies to the skin. The data are in the numbers: about one out of five healthcare professionals who frequently use products containing chlorhexidine suffers from contact allergic dermatitis.
Their hands felt like they were on fire,” confirms Scottish nurse Thomas P. For a long time, he was using antimicrobial soap containing chlorhexidine until they realized that the soap caused inflammation and skin irritation in several patients. “We now know the skin reactions were due to the soap we used. Unfortunately, this diagnosis is not rare,” says the nurse.
As time passed, the condition became more demanding on the caretaker. Thomas recalls, “Not only were my hands inflamed, but in some places, even my forearms. In the end, my hands turned bright red, and I had to see a doctor.” A rubbing method using Sterillium(r) disinfectant instead of soap with chlorhexidine improved the situation. “Since then, I haven’t had any skin reactions or inflammation. It saved my career!” Thomas claims. Thomas.
Research confirms the experience of caregivers. Several studies demonstrate that alcohol-based hand disinfectants that contain modern care ingredients produce significantly less dryness and irritation to the skin than antimicrobial or soap-based detergents. Since 2018, the U.S. Food and Drug Administration (FDA) has eliminated chlorhexidine from its list of products that are “Generally Recognized as Safe and Effective.”
If hospitals favor rub, the efficacy of the product they select is also crucial. The main question is if hand disinfection will kill pathogens with the same efficiency as antimicrobial soap.
Different studies have proven that disinfectants like Sterillium(r) have similar or even superior outcomes in terms of reducing the amount of microbial burden than soaps based on chlorhexidine. It is especially true in regards to long-term effectiveness. When you use an alcohol-based hand cleanser, The reduction in the amount of microbial burden on the skin can be assured within three or more hours.
However, bacteria are becoming intolerant to chlorhexidine. Since the agent has been in use for more than 70 years, the pathogens have had ample time to adjust to its active ingredients and devise strategies to resist them. A similar resistance to pure alcohol disinfectants, however, has yet to be found.
Another benefit of disinfectants like Sterillium(r) can be that they could save hospitals lots of time. For instance, washing your hands before operations can take approximately 5-6 minutes for each procedure. Rub method, however, typically takes just 90 minutes. It may sound like a little to you, but the savings add up. When calculated over an entire year and within a facility that performs 30,000 surgical procedures annually, around 1,750 working hours could be saved.
There’s a substantial economic benefit for hospitals that switch from scrub to rub. Less water costs and energy use, thousands of hours saved each year, and less time lost because of occupational skin conditions.
For a more precise estimate, the savings can range from approximately $280,000 to $348,000 for each operating theater annually. This includes the cost of the operating room, personnel, towels, water brushes, and water filters if the personnel are primarily disinfecting their hands instead of washing them prior to each procedure. Hand disinfection using surgical techniques can reduce expenses by as much as 67 percent.