The effects of'in-use'surgical handwashing on the pre-and postoperative fingertip flora during cardiothoracic and orthopaedic surgery.
Two operating teams (25 persons) were followed for two months with fingerprint samples taken preoperatively ; before and after'in-use'surgical handwashing ; and immediately postoperatively, with and without surgical gloves.
The mean time for handwashing for the cardiothoracic team (CT) was 2 min and for the orthopaedic team (OT) was 3.5 min.
A closer observation of 10 persons revealed a great individual variation in washing techniques, in spite of standard guidelines.
The CT team performed eight, and the OT team nine sterile operations with an average duration of 3 h and 20 min and 2 h and 40 min, respectively.
Surgical handwashing resulted in fingertip sterility in 111/118 (94.1%) cases ; in 61/66 (92.4%) samples from the surgeons and in 50/52 (96.2%) samples from the assistants.
Postoperative fingerprinting with gloves on showed sterile conditions in 85/91 (93.4%) samples ; 57/59 (96.6%) from the surgeons and 28/32 (87.5%) from the assistants.
Immediately after removal of the gloves, 43/67 (64.2%) of fingerprint samples from the surgeons and 13/48 (27.1%) from the assistants were still sterile.
Coagulase-negative staphylococci (CNS) and Bacillus species predominated in fingerprint samples.
Of the 105 CNS strains tested, 11.4% were methicillin resistant.
Only five strains of Staphylococcus aureus were isolated ; in 4/5 cases from the OT.
This study illustrates that in spite of standard guidelines, there is great individual variation in surgical handwashing.
Mots-clés Pascal : Chirurgie orthopédique, Coeur, Thorax, Méthode fingerprint, Lavage, Main, Gant, Exploration microbiologique, Test sensibilité médicamenteuse, Antibiotique, Hôpital, Colonisation, Hygiène
Mots-clés Pascal anglais : Orthopedic surgery, Heart, Thorax, Fingerprint method, Washing, Hand, Glove, Microbiological investigation, Drug susceptibility test, Antibiotic, Hospital, Colonization, Hygiene
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0476527
Code Inist : 002B25I. Création : 01/03/1996.