Evaluation of the impact of a novel surgical handwashing method on reformation of microbial flora on surgeons’ hands

Abstract Objective: The purpose of surgical hand antisepsis before surgical or invasive procedures is to suppress microbial flora on the hands. This study aimed to evaluate the effect of a modified surgical hand antisepsis technique on recolonization of microbial flora on surgeons’ hands over time. Methods: Participating surgeons were randomly assigned to one of two study groups. In both groups, surgical hand antisepsis was performed using 10% povidone-iodine followed by rinsing of the hands and forearms. In Group 1, surgeons dried their hands after rinsing according to the conventional method. In Group 2, surgeons applied an additional layer of 10% povidone-iodine to the still-wet hands and forearms after rinsing and then allowed the solution to dry without further rinsing. Hand cultures were obtained immediately after antisepsis (0 hour) and at 1 and 2 hours thereafter. Colony-forming units (CFUs) were counted and compared between groups and sampling periods. Results: Fourteen surgeons participated in the study, with seven surgeons allocated to each group. No significant difference in bacterial growth was observed between the groups at 0 hour (Group 1: mean CFU 41.59 ± 72.53 vs Group 2: 18.63 ± 24.27, P = .27). At 1 hour, bacterial growth was significantly lower in Group 2 compared with Group 1 (8.43 ± 20.65 vs 25.44 ± 53.62 CFU, P = .001). Similarly, at 2 hours, Group 2 demonstrated significantly lower bacterial growth than Group 1 (16.37 ± 34.25 vs 32.88 ± 52.55 CFU, P = .022). Conclusion: Compared with the conventional surgical handwashing technique, reapplication of povidone-iodine without a final rinse resulted in significantly reduced bacterial recolonization on surgeons’ hands at 1 and 2 hours after hand antisepsis. These findings suggest that this modified technique may provide prolonged antimicrobial activity during surgical procedures. Further large-scale studies are warranted to confirm its clinical utility.