6.1Hand decontamination

Bibliographic detailsStudy type and evidence levelNo. of patientsPatient characteristicsIntervention and comparisonfollow-up, outcome, effect sizeComments
Parienti 200293
France
Cluster Randomised Trial

EL = 1+
Total no. of patients
n = 4823

Hand-rubbing Protocol
n = 2342

Hand-scrubbing Protocol
n = 2481

4387 patients were included in the as- treat analysis:
hand- scrubbing group n = 2135
hand- rubbing group n = 2252
Patients having surgery at six surgical services from teaching and non-teaching hospitals in France

Exclusion criteria: patients with contaminated or dirty procedures, patients having a second surgery < 15 days after the first intervention
Three surgical services were allocated to begin with the hand-rubbing protocol and the other three with the hand-scrubbing protocol.

* At the end of 1 month, each service switched to the alternative protocol.
The study lasted 16 months

Intervention1: Hand-scrubbing protocol (5 minutes scrub using either 4% povidone iodine or 4% chlorhexidine gluconate)

Intervention2: Hand-rubbing protocol (5 minutes hand rub with 75% aqueous alcoholic solution)
Follow-up
30 days

Outcome
SSI rate (CDC definition)

Effect size
Hand-scrubbing
53/2135 (2.48%)

Hand-rubbing
55/2252 (2.44%)
Funding
French government grant

Comments
436 patients were excluded after randomisation because of contaminated/dirty surgery (385) or lost to follow-up (51).

From: Evidence tables

Cover of Surgical Site Infection
Surgical Site Infection: Prevention and Treatment of Surgical Site Infection.
NICE Clinical Guidelines, No. 74.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2008 Oct.
Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

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