Comparison of bacterial eradication between standard and double-painted antiseptic application method in minor hand surgery

Background: Bacteria need to be eliminated for skin preparation in minor hand surgery. The standard method of skin preparation uses an antiseptic scrub and antiseptic solution, which is expensive and time-consuming.

Objective: Design a “double-painted antiseptic application method”, and compare the effectiveness of eliminating bacteria at the area around the hand and wrist between the standard method and the double-painted antiseptic application method.

Methods: This cross-over designed experimental study was performed on seven volunteers. The standard and the double-painted antiseptic application method were alternately used for skin preparation around the hand, wrist, and half of the forearm. The bacterial colony counts were collected before, immediately after, and at 45 minutes after skin preparation by using the modified glove-juice technique. The primary outcomes were the eradication rate and the number of bacterial colonies.

Results: There was no statistical difference in bacterial colonies between either method before skin preparation. The median of bacterial colony counts immediately after and at 45 minutes after skin preparation were zero colony forming units per milliliter in both methods. The eradication rate was 61.5% and 76.9% in the standard and double-painted antiseptic application method, respectively, for a risk difference of -15.4. There was no statistically significant difference (p=0.67).

Conclusion: The number of bacterial colonies and eradication rate were not significantly different between either method. The double-painted antiseptic application method can be used instead of the standard method for the skin preparation in minor hand surgery, which has an expected duration of about 45 minutes or less.