Vol. 5, Issue 3, Part A (2021)

Author(s): Dr. Satish Deshmukh, Dr. Sushrut Fulare and Akhilesh Gokhale

Abstract: Introduction: One of the important causes of morbidity and mortality in post-surgical period is surgical site infection [1]. The main carrier of nosocomial and multi-drug resistant bacterial infection in hospital setting are healthcare workers [2]. Surgical site infections are avoidable with proper methodical antisepsis. The traditionally used disinfectant for hand antisepsis is povidone iodine. Newer Alcohol based hand rubs are present in commercial market, there are very few clinical studies that suggest the efficacy and comparison between povidone-iodine and alcohol based hand rubs in the pre surgical settings. There is a need to evaluate the antimicrobial based comparison between the hand antisepsis methods for better surgeon compliance and providing quality treatments to the patients. This study provides a basis in opting for a better alternative amongst the presurgical hand antisepsis methods. Methods: An observational study was conducted at a tertiary care rural hospital. Patients undergoing clean surgeries were included in the study. The subjects representing the surgeons and the paramedical staff (n=200) were divided into two groups of 100 each (povidone iodine and alcohol based hand rub). Samples were then collected using sterile gloves and sterile culture tubes and were sent to the microbiology department for obtaining cultures. The efficacy of surgical hand antisepsis methods were compared, surgical site infection occurrences if found were accessed for seniority of surgeon, noted to deduce any relationship with the organism found on hand swabs and results were calculated. Result: In concern with the two groups of hand antisepsis, bacterial growth profile was obtained, results showed a positive culture of 7% of which 4.5% positive cultures were found in Group A(povidone iodine) for Staphylococcus, Acinetobacter, Pseudomonas spp. and Streptococcus and 2.5% belonged to group B (Alcohol based hand rub) for Staphylococcus and Klebsiella. The statistical comparison of both groups A and B was done to calculate the p value which came out to be 0.267 which is not significant. Conclusion: In 7% hand swabs the culture was positive for bacteria, with staphylococcus being the most common isolated commensal. No significant difference in efficacy of hand antisepsis was established in reducing the bacteria in surgical hand antisepsis protocol. No association was found between type of hand scrub and seniority of the surgeons. Since there was no incidence of surgical site infection in the patients, the better alternative between types of hand rub could not be deduced.