Abstract
Introduction
The daily observation of surgical preoperative preparation prompted us to review and investigate the quality of water used during preoperative hand antisepsis.
Material and Methods
In this prospective study, the process of water sampling took place on two different days over a period of one week. The procedure required the collection of two samples of water from each of the three taps on the same day. The first sample was collected at 8am and the second at 3pm. In both cases, the water was collected either immediately after opening the tap (direct intake), or after using a torch to sterilize the tap and letting the water flow for five minutes (indirect intake). Thereafter, the taps’ filters and pipes were immersed into sodium hypochlorite solution 5% (solution 1:10) for thirty minutes and new samples were taken a week later. Bottles with 500ml capacity were used for the samples a nd were sealed immediately, avoiding any contact of the inner surface with the hands. Ten percent of the bottle remained empty for good mixing prior to analysis. To enable their transportation, the samples were immediately cooled with ice bags in special insulated boxes. The samples from indirect water intake remained in the refrigerator at 5o C and the transfer took place the next morning at 8am.
Results
Overall, 24 samples of water from three taps over two different days were included in the study. During direct intake from taps 1, 2 and 3, non-pathological levels of Pseudomonas Aeruginosa was detected (taps 1 and 2 >100 and tap 3 <4). Indirect intake from taps 1 and 2 also showed the presence of Pseudomonas Aeruginosa (tap 1 >100 and tap 2 <10); again, this is a non-pathological result. In the new samples, the immersion of the taps’ filters and pipes only revealed the presence of Pseudomonas Aeruginosa (<4) in tap 1 during direct intake. From taps 2 and 3, no microorganism was detected. Similarly, no microorganism was observed from indirect intake.
Conclusions
The use of tap water for surgical hand scrub is acceptable. However, regular maintenance of pipelines and the distribution network, the examination of the water, and disinfection of the taps is mandatory. Furthermore, the regular use of an alcohol-based hand antiseptic for a time period of 180 seconds following surgical hand scrub is an effective combination against possible pathogens present in tap water.
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References
Hamman ur Rehman, Allah Yar Malik Shahid Mansor Nizami, Asim Shafi. Surgical hand Antisepsis: What Surgeons need to know. Nishtar Medical Journal 2010; 2:14–22
Σέχασ N.M. gCɛιρoυργική, Eκδόσɛισ Πασχαλίδη Aθήνα, 1996; 1:20–22
Golditch IM, Lawson T. The forgotten gynecologist. Obstetrics and Gynecology 2002; 99:152–156
Zimmermann M. Life and Work of the Surgeon Ernst von Bergmann (1836–1907). Zentrablatt für Chirurgie, Germany 2000; 125:522–560
Heeg P, Ostermeyer C, Kampf G. Comparative review of the test design Tentative Final Monograph (TFM) and EN 12791 for surgical hand disinfectants. J Hosp Infect 2008; 70(Suppl 1):22–26
Rotter ML. European norms in hand hygiene. J Hosp Infect 2004; 56(Suppl 2):6–9
Furukawa K, Tajiri T, Suzuki H, Norose Y. Are sterile water and brushes necessary for hand washing before surgery in Japan. J Nippon Med Sch 2005; 72:149–154
Burch TM, Stanger B, Mizuguchi KA, Zurakowski D, Reid SD. Is alocohol-based disinfection equivalent to surgical scrub before placing a central venous catheter?. AnesthAnalg 2012; 114:622–625
Blank DS, Nahimana I, Petignat C, Wenger A, Bille J, Francioli P. Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in ICU. Intensive Care Medicine 2004; 30:1964–1968
Kampf G, Ostermeyer C, Heeq P. Surgical hand disinfection with a propanol-based hand rub: equivalence of shorter application times. J Hosp Infect 2005; 59:304–310
Wheelock SM, Lookinland S. Effect of surgical hand scrub time on subsequent bacterial growth. AORN J 1997; 65:1087–1092, 1094–8
Suchomel M, Kundi M, Allegranzi B, Pittet D, Rotter ML. Testing the WHO -recommended formulations for surgical hand preparation and proposals for increased efficacy. J Hosp Inf 2011; 79:115–118.
Nishirama C. Comparison of the antimicrobial efficacy of povidone-iodine,povidone-iodine-ethanol and chlorhexidine gluconate-ethanol surgical scrubs. Dermatology 2006; 212(Supll 1):21–25
Lai KW, Foo TL, Low W, Naidu G. Surgical hand antisepsis-a pilot study comparing povidone -iodine hand scrub and alcohol based chlorhexidine gluconate hand rub. Ann Acad Med Singapore 2012; 41:12–16
Gupta C, Czubatyi AM, Briski LE, Malani AK. Comparison of two alcohol -based surgical scrub solutions with an iodinebased scrub brush for presurgical antiseptic effectiveness in a community hospital. J Hosp Inf 2007; 65:65–71
Rotter ML, Kampf G, Suchonel M, Kundi M. Population kinetics of the skin flora on gloved hands following surgical hand disinfection with 3 propanol based hand rubs: a prospective randomized, double -trial. Inf Control and Hosp Epidem 2007; 28:346–350
Olson C, Savell BK. Prospective, randomized in vivo comparison of a dual-active waterless antiseptic versus two alcoholonly waterless antiseptics for surgical hand antiseptics. Am J Infect Control 2012; 40:155–159
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Voultsou, S., Stamatakis, E., Hadzilia, S. et al. Is tap water safe for surgical hand washing?. Hellenic J Surg 85, 369–373 (2013). https://doi.org/10.1007/s13126-013-0068-7
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DOI: https://doi.org/10.1007/s13126-013-0068-7