Hand Disinfection
Good theatre practice includes thorough hand washing by surgical staff between patients, together with effective hand disinfection prior to gloving for surgical procedures. Gross contamination must be removed and particular attention must be paid to the nails, the first scrub of the day being the most critical. Vygon Vet offers a range of sterile single-use scrub brushes and nail picks to assist surgeons in maintaining good nail hygiene.
Two antimicrobials are commonly used for pre-surgical hand preparation; chlorhexidine and povidone-iodine solutions. Both are available in the impregnated scrub brush range from Vygon Vet. Povidone-iodine solutions release free iodine, which diffuses through the microbial cell wall to inhibit protein synthesis. Release of free iodine takes time and it is important to allow skin contact for at least two minutes. Iodine has a wide spectrum of activity against bacteria, mycobacteria, protozoa, fungi, yeasts and viruses, including some non-enveloped types. Povidone-iodine solutions can produce skin reactions in some individuals.
Chlorhexidine is a rapid-acting antimicrobial agent which alters cell wall permeability and precipitates intracellular contents. Chlorhexidine is more effective against gram positive compared to gram negative bacteria, and has no activity against mycobacteria or non-enveloped viruses. It is effective against yeasts, with variable effectiveness against fungi. Neither of these antimicrobials kill spores well in routine clinical use. Povidone-iodine solutions have an effect after prolonged contact, chlorhexidine requires elevated temperatures for any activity. Chlorhexidine binds to the stratum corneum of the skin and has excellent residual activity. Studies have shown superior performance of this compound over povidone-iodine in many clinical situations. Skin reactions to chlorhexidine are uncommon.
Handwashing Technique
Hand washing products from Vygon Vet:
Dry and impregnated surgical scrub brushes, sponges & nail picks
© Vygon (UK) Ltd 2009