EQUINE | Abstracts
Prospective, randomised clinical trial of four different
presurgical hand antiseptic techniques in equine surgery
N. M. Biermann, J. T. McClure, J. Sanchez, M. Saab, A. J. Doyle
Background Results
Objectives Main limitations
Study design Conclusions
Currently, the World Health Organization recommends
the use of alcohol‐based hand rubs (ABR) for surgical
hand preparation in human surgery. When disinfecting
soaps are used, a rubbing technique causes less skin
irritation than brush scrubbing. Based on a recent
survey, most equine surgeons still use disinfecting
soap. The efficacy of scrubbing vs. rubbing and the
use of sole ABR compared with chlorhexidine (CHx)‐
based products has not been evaluated in the equine
surgical setting.
To compare four surgical hand antisepsis techniques
in equine surgery for reduction of aerobic bacterial
counts from pre‐ to post‐preparation (immediate
efficacy) and at the end of surgery (sustained efficacy).
Randomised, prospective clinical trial.
Methods
A 4% CHx‐based product applied with either a
scrub or rub technique, one sole ABR (IPO; 30% 1‐
propanol and 45% 2‐propanol) and one CHx/alcohol‐
combination (CHx/ET; 1% CHx and 61% ethanol)
product both applied with a rub technique were
evaluated. Samples were collected by glove juice
technique and cultured on 3M™ Petrifilm plates and
counted using a 3M™ Petrifilm plate reader.
20
Immediate mean bacterial log10 colony forming unit
(CFU) reduction was 2.4 for CHx‐scrub, 2.8 for CHx‐
rub, 3.1 for CHx/ET and 2.1 for IPO. CHx/ET resulted in
significantly lower bacterial counts than CHx‐scrub
(P<0.005) and IPO (P<0.001) while CHx‐rub resulted in
significantly lower counts than IPO (P<0.001). At the
end of surgery bacterial counts were the lowest for CHx‐
rub, significantly lower than CHx/ET (P<0.001) and IPO
(P<0.001). There was no difference between CHx‐rub
and ‐scrub techniques (P = 0.7).
Bacterial counts were used as the outcome measure
rather than prevalence of surgical site infection, and
the effect of hand preparation on skin health was not
assessed.
ABR did not decrease bacterial log10CFU counts
more effectively than CHx products. When using CHx
soaps in the equine setting, hand‐rub is as effective as
a hand‐scrub‐technique.
• Equine Health Update •