Scientific article

Comparing surgeons' skin tolerance and acceptability to alcohol-based surgical hand preparation vs traditional surgical scrub: A matched quasi-experimental study

Published inAmerican journal of infection control, vol. 50, no. 10, p. 1091-1097
Publication date2022-10
First online date2022-02-10

Background: We aimed to compare the tolerance and acceptability of alcohol-based surgical hand preparation versus handscrubbing with antimicrobial soap and water by surgeons.

Methods: Matched quasi-experimental trial in an academic quaternary care hospital in Ribeirão Preto, Brazil, from April 1 to October, 31, 2017. Participants were cardiac and orthopedics surgeons from the study facility. In the first study phase, they performed handscrubbing with either 2% chlorhexidine (CHG) or 10% iodopovidone (PVP-I) and, in the second phase, they performed handrubbing with alcohol-based handrub (ABHR). Surgeons' skin tolerance and acceptability were evaluated using WHO-validated tools. Data were analyzed using the MacNemar's test within STATA.

Results: A total of 33 surgeons participated to the "per protocol" population; the majority were male (94%); mean age of 35 years (SD, 8.5). On product tolerance, there was a minimal variation in redness, scaliness, fissures, and visual evaluation of the skin when handrubbing with ABHR was compared to handscrubbing with either PVP-I or CHX. Regarding acceptability, participants rated better handrubbing with ABHR than handscrubbing with PVP-I when assessing product smell (66.6% vs 0%, p=0.002), color (73.3% vs 0%, p=0.001), product texture (60% vs 0%, p=0.004), skin dryness (60% vs 0%, p=0.004), ease of application (66.6% vs 0%, p=0.002) and overall satisfaction (66.6% vs 6.7% p=0.011). Participants rated similarly handrubbing with ABHR and handscrubbing with CHX, except for product texture, where handrubbing rated better (71,4% vs. 0%, p=0.002). Handrubbing with ABHR was preferred by 73.3%.

Conclusion: Although handrubbing and handscrubbing were equally well tolerated by surgeons, alcohol-based surgical hand preparation fell into the personal preference for most of them.

Trial registration: Brazilian Clinical Trials Registry (ReBEC), RBR-8ym9yj.

  • Alcohol-based handrub
  • Chlorhexidine
  • Handscrubbing
  • Infection prevention and control
  • Povidone-iodine
  • Skin tolerance
  • Surgical hand preparation
  • Surgical site infection
Citation (ISO format)
LOPES, Ana Elisa Ricci et al. Comparing surgeons” skin tolerance and acceptability to alcohol-based surgical hand preparation vs traditional surgical scrub: A matched quasi-experimental study. In: American journal of infection control, 2022, vol. 50, n° 10, p. 1091–1097. doi: 10.1016/j.ajic.2022.01.028
Main files (1)
Article (Published version)
ISSN of the journal0196-6553

Technical informations

Creation03/02/2022 3:19:00 PM
First validation03/02/2022 3:19:00 PM
Update time03/16/2023 8:40:06 AM
Status update03/16/2023 8:40:05 AM
Last indexation02/01/2024 9:03:47 AM
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