免刷手方法在外科手消毒中的应用

目的 比较免刷手与刷手两种外科手部消毒方法的效果和对皮肤的影响,以提高洗手依从性.方法 研究医院2011年参加手术的医护人员,随机分为对照组和试验组,每组50人,医师、护士各25人;应用同一种外科手洁肤柔免洗手消毒凝胶消毒剂,对照组采用传统的刷手方法进行手部消毒,试验组采用免刷手方法进行手消毒,余均按2009年《医务人员手卫生规范操作》执行,并对手消毒前后对皮肤作细菌和病原菌检测,对同期的600例患者手术切口的感染率进行同步分析.结果 两组手消毒后杀菌率分别为98.12％和97.77％,经检验比较二者差异有统计学意义(P＜0.05);对照组手部消毒时间为(10.28±1.23)min,试验组为(5.65±0.78)min,,试验组与对照组相比手部消毒时间明显缩短,二者差异有统计学意义(P＜0.05);消毒后对照组和试验组的医护人员手部细菌总数明显减少,未测出致病菌,符合消毒技术规范要求;切口感染对照组15例感染率5,0％,试验组12例感染率4.0％,两组比较差异无统计学意义.结论 免刷手与刷手两种手部消毒方法均能达到杀菌要求,消毒效果和手术切口感染率无差异,但免刷手比刷手式手部消毒方法时间缩短,减少了医护人员皮肤的损害,提高了医护人员依从性,值得在临床推广.     

不同清洁洗手方法对外科手消毒效果的影响

目的比较不同的清洁洗手方法对外科手消毒效果的影响。方法使用同种手清洁剂和外科手消毒剂,分别采取揉搓清洁洗手(A组)、刷洗清洁洗手(B组)和不进行清洁洗手(C组)3种方法后按同样的方法进行外科手消毒,比较其即刻消毒效果和对手部皮肤的影响。结果 C组外科手消毒后手部菌落数(0.27±0.45)CFU/cm2及手部带菌阳性率(46.7%)明显高于A组和B组,差异有统计学意义(P<0.01),A组和B组之间比较,差异无统计学意义,均有较好的即刻消毒效果,但刷洗法对皮肤损伤较大。结论外科手消毒前推荐使用揉搓清洁洗手方法。     

外科免洗手消毒液对手术人员手部皮肤消毒效果与不良反应的调查

目的调查百能外科免洗手消毒液对手术人员手部皮肤消毒的效果、不良反应和依从性。方法采用百能外科免洗手消毒液和0.5%聚维酮碘消毒液分别对100人次手术人员的手部皮肤消毒,监测消毒后即刻、60、120、180 min手部皮肤的细菌菌落数,观察两组消毒后手部皮肤不良反应发生率和依从性。结果两组消毒效果均达到国家标准,百能外科免洗手消毒液对手部皮肤不良反应的发生率(1.0%)显著低于0.5%聚维酮碘消毒液(12.0%),依从性好。结论百能外科免洗手消毒液与0.5%聚维酮碘消毒液均能满足外科手消毒的要求,百能外科免洗手消毒液对手部皮肤不良反应发生率低,使用更安全、舒适,依从性好。     

免刷手式外科手消毒法的临床应用与研究

目的：观察免刷式外科手消毒法在临床中实际消毒效果。方法：研究医院2013年参加择期手术的医护人员200人次,随机分为对照组和实验组,每组100人次;应用同一种洗手液和消毒液（手洁肤柔抗菌洗手液和消毒凝胶）,将采用免刷手消毒法作为实验组,采用刷洗外科手消毒法作为对照组,对两种外科手消毒法进行分析,并比较两组消毒后的无菌率和操作时间。结果：免刷手式外科手消毒方法消毒效果达到卫生部《消毒技术规范》,且操作时间短,对皮肤损害小,得到医院医护人员的肯定。     

两种外科手消毒方法效果研究

目的探讨两种外科手消毒方法的消毒效果及对消毒部位皮肤的影响。方法将200名参与者随机均分为研究组和对照组两组。研究组采用搓擦法进行外科手消毒,对照组采用传统刷洗法进行外科手消毒。比较两组的消毒合格率和消毒部位皮肤不良反应发生率。结果两种方法均能达到100%消毒合格率。研究组没有皮肤不良反应发生,对照组皮肤不良反应发生率为6.0%,两组间不良反应发生率比较有显著性差异(p<0.05)。结论采用搓擦法进行外科手消毒,能同样达到100%合格率,且减少皮肤不良反应。     

免洗手泡沫消毒液在外科手消毒中应用的效果观察

目的 探讨免洗手泡沫消毒液在外科手消毒中的应用效果.方法 对手术人员外科洗手随机应用葡泰免洗手泡沫消毒液洗手法与刷手、聚维酮碘消毒洗手法,通过手部微生物采样监测,发放调查表对皮肤舒适度和接受程度进行调查,并对两种洗手法的成本进行分析.结果 葡泰免洗手泡沫消毒液消毒作用持久,抑菌时间＞6 h,洗手成本(0.50元/人次)低于聚维酮碘手消毒法(0.62元/人次),皮肤不良反应少,医务人员接受度高,为8 8.5%.结论 葡泰免洗手泡沫消毒液洗手法是一种好的洗手方法,值得推广.     

丹尼尔皮肤消毒液用于外科洗手的临床评估

丹尼尔皮肤消毒液是一种速效、免水洗、无刺激的复合型消毒剂。2004年4月我院手术室开始试用丹尼尔外科刷手液和皮肤消毒液替代0·5%碘伏用于手术前手消毒,并根据卫生部2002年版《消毒技术规范》,消毒前后手指样本进行细菌培养与碘伏洗手比较,报道如下。1对象及方法1·1对象随机抽取手术室医师和护士160名,其中用刷手液和丹尼尔皮肤消毒液、0·5碘伏消毒者各80名。1·2方法(1)采样:受试者按《规范》用肥皂清洁双手>15mim,清洁毛巾擦干,左手手指并拢,用沾有无菌生理盐水的棉拭子,在五指屈面从指尖至指根往返涂抹两次,将棉拭子端折断置入培养…     

手术前洗手消毒效果调查分析

洗手是手术前手术人员对手和臂消毒的常规措施,对预防手术切口的外源性感染有重要的意义,为了解术前洗手消毒效果,我们对手术前手术人员洗手消毒效果进行了调查。1方法1.1洗手方法在流水肥皂洗手的基础上,取无菌小刷蘸消毒剂约5 ml涂抹手、臂。从指尖到肘上10 cm,两手交替刷,注意指甲沟、指间、腕部等处,按顺序进行,无遗漏,约2 min,无菌水冲洗。换无菌刷蘸取消毒液约5 ml,刷手、臂2 min后取无菌擦手巾擦干。1.2消毒手、臂擦拭法:双手和前臂刷洗完毕,用无菌水冲洗干净后,将主要成分为氯己定一醇(异丙醇或乙醇)速效消毒液涂擦于手和前臂,约1 m…     

汰可分外科手部皮肤消毒临床效果观察

目的 检测汰可分(Decosept)皮肤消毒剂实用消毒效果。方法 随机将手术人员分为汰可分组和碘伏组，每组30人；按消毒技术规范进行外科手皮肤消毒试验；中和剂按中和剂试验确定。结果 汰可分组杀灭率为99.43％，碘伏组为99.26％，二者差异无显著性。结论 术者严格按外科刷手消毒操作，汰可分可使双手消毒后无菌生长且无毒副作用。     

3种外科手消毒剂临床效果观察

目的检测美逸柔、汰可分、安高特3种皮肤消毒剂的临床消毒效果. 方法将参加手术人员随机分成3组,每组30人;按产品使用说明进行外科手消毒后,按消毒技术规范要求进行皮肤消毒实验. 结果 3种消毒剂的消毒效果及持续抑菌效果无显著差异. 结论安高特是外科手消毒较理想的化学消毒剂,消毒效果好、价廉、使用方便.     

术前手消毒效能检测及对策

为了解我院外科手术前刷手及手消毒状况 ,特组织了一次术前刷手后手消毒效果调查 ,现报道如下。1　对象与方法1 .1　调查对象　我院 2 0 0 2年 4月 1日～ 6月 2 6日手术室术前刷手及手消毒医务人员。1 .2　方法　按《消毒技术规范》要求进行外科手术前手消毒[1] ;按《医院消毒卫生标准》要求进行采样[2 ] 。2　结果2 .1　阳性率　共调查采样手术人员 1 97人次 ,有1 4份阳性标本 ,细菌阳性率为 7.1 1 % (其中进修生和实习生 1 0人 ,占阳性率的 71 .4 3% ) ;手术人员指甲过长者 2人 ,培养均为阳性 ,占阳性率的 1 4 .2 9%。2 .2　病原菌　共培…     

一种净手消毒剂对手的消毒效果观察

目的：观察以氯羟二苯醚为主要杀菌成分的净手消毒液对手的消毒效果。方法：依据《消毒技术规范》（2002版）2.1.1.5和2.1.2.6的要求,进行了中和剂的选择试验,并随机抽取30名志愿受试者进行手的消毒现场试验。结果：用含10 g/L Na2S2O3＋5 g/L卵磷脂＋2.5%吐温80的PBS缓冲液作为中和剂,可有效中和该净手消毒剂原液的残留作用,且中和剂和中和产物对试验菌及培养基均无不良影响。经30人次手的消毒现场试验结果表明,用该消毒剂消毒处理后,可使志愿受试者手上自然菌的平均杀灭对数值达到1.29。结论：该净手消毒剂对手上的自然菌具有良好的杀灭效果。     

Povidone-iodine and chlorhexidine gluconate-containing detergents for disinfection of hands

The efficacy of a povidone-iodine and a chlorhexidine gluconate detergent was evaluated for ‘hygienic’ and ‘surgical’ hand disinfection. Rubbing 60 per cent iso-propanol on to the hands for 1 min was used as a standard for ‘hygienic’ disinfection, with Escherichia coli as the test organism. The mean log reduction obtained was 3.16 with povidone-iodine and 2.92 with chlorhexidine. These were considerably less than obtained with iso-propanol which produced a reduction of 4.23 and 4.30 orders of magnitude. In the ‘surgical’ hand disinfection tests, a 5 min wash with povidone-iodine and a 3 min wash with chlorhexidine detergent were compared with rubbing 60 per cent n-propanol or iso-propanol on to the hands for 5 min; n-propanol was taken as the standard preparation. Immediately after disinfection the log reduction in the resident flora was 0.92 with povidone-iodine and 0.78 with chlorhexidine, whereas n-propanol gave a log reduction of 3.43. After wearing a surgical glove for 3 h a log reduction of 0.24 was obtained with povidoneiodine, 0.75 with chlorhexidine and 2.94 with n-propanol. Treatment with iso-propanol gave a log reduction of 1.04. Thus, alcohols are shown by these tests to be far more effective than povidone-iodine or chlorhexidine detergent preparations in ‘hygienic’ as well as ‘surgical’ hand disinfection.     

Suitability of Sterillium Gel for surgical hand disinfection

In some countries, alcohol-based hand gels are used for hygienic hand disinfection but their efficacy and suitability for surgical hand disinfection has never been investigated. The efficacy of Sterillium Gel was investigated according to prEN 12791 in two separate experiments. Finger tips of 20 volunteers per experiment were sampled for resident skin bacteria before surgical hand disinfection. In a cross-over design, each volunteer carried out a surgical hand disinfection with the reference alcohol [n-propanol 60%, (v/v)] or Sterillium Gel [ethanol 85% (v/v)] for 3 min. After the product application, one hand was sampled for the immediate effect, the other hand was gloved for 3 h and then sampled for the sustained effect. Samples were analysed for remaining resident bacteria. The mean of the pre-value, the 0 h and 3 h values of the reference disinfection and the test product were calculated. With the reference alcohol, respective mean immediate log10-reduction factors of 2.06+/-0.76 and 2.23+/-1.13 were found in both experiments. The mean sustained effects with the reference alcohol were 2.03+/-1.14 and 1.44+/-0.81. Sterillium Gel achieved respective mean immediate effects of 2.48+/-1.06 and 2.13+/-0.81, the mean sustained effects were 2.77+/-0.95 and 2.18+/-0.72. They proved significantly larger than those obtained with the reference alcohol (P<0.05; pair-wise Wilcoxon test). Sterillium Gel, therefore, more than fulfils the efficacy requirements for surgical hand disinfection of prEN 12791. In addition, 25 of 26 operating theatre healthcare workers in an orthopaedic hospital found it suitable for surgical hand disinfection after a single use, which included putting on a pair of surgical gloves. Although none of them had ever used an alcohol-based gel before, they had rather been accustomed to alcohol-based liquid products for years. The main reasons given for the positive assessment were better skin feeling after use, smell and easier donning of the surgical gloves. No significant correlation was found between overall or dermal acceptance and years of professional experience, profession or number of gel portions used for surgical hand disinfection (Pearson's correlation; P>0.05).