Effective surgical hand preparation: An integrative research review

Abstract

The aim of this paper is to present an integrative literature review on the effectiveness of surgical hand preparation. Six electronic databases were searched between the years 2000 and 2011. During this time, 21 studies were included as they presented detailed and substantive information about any aspect on effective surgical hand preparation. Effectiveness was measured in a reduction of surgical site infection (SSI)/bacterial counts. Topics were clustered around the following categories: choice of surgical hand preparation solutions, surgical hand preparation techniques, and duration required for surgical hand preparation. Outcomes of the integrative research review (IRR) found, firstly, chlorhexidine surgical scrub solution is more effective than povidone-iodine in reducing 551/bacteria counts. Secondly, there is no difference in reduction of 551/bacteria counts when performing a surgical scrub with brushes. Thirdly, there is no difference in durations of applying surgical hand preparation solutions (two, three, five or 10 minutes). There are no consistent results from studies that examined surgical hand preparation techniques of scrub versus rubs. It is suggested that the application of universal practice guidelines are needed to ensure the effectiveness of surgical hand preparation. Further research is required to determine the effectiveness of surgical hand rubs in comparison to surgical scrubs.