TEMİZ SU KAYNAKLARI AZALIRKEN CERRAHİ EL HAZIRLIĞINDA GELENEKSEL YÖNTEM Mİ SUSUZ EL ANTİSEPSİSİ Mİ?

Year 2020, Volume: 3 Issue: 2, 112 - 129, 20.12.2020

Aysel Gül Dilek Aygin

Abstract

İnsan sağlığı açısından temiz su kaynaklarına erişimin önemi tartışılamaz. Sağlıklı suyun kullanımı enfeksiyonların ve buna bağlı hastalıkların önlenmesinde elzemdir. Günümüzde cerrahi el hazırlığı, geleneksel el antisepsisi ve susuz el antisepsisi olarak gruplandırılabilmektedir. Geleneksel el antisepsisinin, cilt bütünlüğüne zarar verme ve alerjik reaksiyonlara zemin hazırlama gibi istenmeyen etkileri bulunmakta, bu da bakteriyel kolonizasyon riskini arttırarak cerrahi alan enfeksiyonlarına (CAE) zemin hazırlamaktadır. Susuz el antisepsisi, kullanımının kolay ve adaptasyonunun yüksek olması, su ve zaman tasarrufu sağlaması ve cilt tahrişini minimal düzeylere indirmesi gibi birçok avantaja sahiptir. Su kaynaklarına erişimin güç olduğu günümüz dünyasında, sağlık profesyonelleri açısından cilde zarar vermeyen, uygulama kolaylığı olan, enerji, zaman ve su tasarrufu sağlayan, ekonomik ve CEA’nı önlemede etkili olan cerrahi el antisepsisine olan ihtiyaç her geçen gün artmaktadır. Bu derleme makalenin amacı, cerrahi öncesi el hazırlığında geleneksel el antisepsisi ile susuz el antisepsisi yöntemlerini karşılaştıran çalışmaları inceleyerek, her iki yöntemin de avantajlarını ve dezavantajlarını ortaya koymak, sağlık profesyonellerine yeni yöntemleri denemeleri ve bu konuda deneysel çalışmalar yapmaları için farkındalık yaratmaktır.

Keywords

antisepsi, enfeksiyon, cerrahi el yıkama

WHILE THE CLEAN WATER RESOURCES DECREASES, IN SURGICAL HAND PREPARATION, SHOULD TRADITIONAL METHODS OR SHOULD WATERLESS HAND ANTISEPSIS BE USED ?

Abstract

The importance of access to clean water resources for human health cannot be discussed. The use of healthy water is essential in preventing infections and related diseases. Nowadays, surgical hand preparation can be grouped as traditional hand antisepsis and waterless hand antisepsis. Traditional hand antisepsis has undesirable effects such as damaging the integrity of the skin and preparing the ground for allergic reactions, which increases the risk of bacterial colonization and paves the way for surgical site infections (SSI). Waterless hand antisepsis has many advantages, such as being easy to use and highly adaptable, saving water and time, and minimizing skin irritation. In today's world where access to water resources is difficult, the need for surgical hand antiseptic, which does not harm the skin for health professionals, is easy to apply, saves energy, time and water, and is effective in preventing SSI, is increasing day by day. The aim of this review is to examine the studies comparing traditional hand antisepsis with waterless hand antisepsis in hand preparation before surgery, to reveal the advantages and disadvantages of both methods, to raise awareness for health professionals to experiment with new methods and to do experimental study on this subject.

Keywords

antisepsis, infection, surgical scrubbing

References

• Swain A. Water wars. In Wright JD, International Encyclopedia of the Social & Behavioral Sciences. 2nd Edition. Oxford: Elsevier; 2015: 443-447. URL: https://www.researchgate.net/profile/Ashok_Swain2/publication/275209001_Water_Wars/links/59d6b004a6fdcc52aca7d2db/Water-Wars.pdf?origin=publication_detail. 10.09.2019.
• Wang R, Zimmerman J. Hybrid analysis of blue water consumption and water scarcity implications at the global, national, and basin levels in an increasingly globalized world. Environmental Science & Technology. 2016;50(10):5143-5153.
• Arto I, Andreoni V, Rueda-Cantuche JM. Global use of water resources: A multiregional analysis of water use, water footprint and water trade balance. Water Resources and Economics 2016;15:1-14.
• Northfield Hospital and Clinics. Keeping hydrated – Why is water important?. URL: https://www.northfieldhospital.org/keeping-hydrated-%E2%80%93-why-water-important. 15.09.2019.
• Ginty O. Why hospitals should have clean drinking water?. URL: https://www.ewtechnologies.ie/hospital-clean-drinking-water/. 15.09.2019.
• Collett S, Samarin I, Bhalchandra R, Soundaranayagam JR, Garai S, Chandy M, et al. Water usage in a multi-speciality hospital and its effective management. Journal of the Academy of Clinical Microbiologists. 2016;18(2):135-137.
• Omling E, Jarnheimer A, Rose J, Björk J, Meara JG, Hagander L. Population-based incidence rate of inpatient and outpatient surgical procedures in a high-income country. The British Journal of Surgery. 2018;105(1):86-95.
• Dall TM, Gallo PD, Chakrabarti R, West T, Semilla AP, Storm MV. An aging population and growing disease burden will require a large and specialized health care workforce by 2025. Health Affairs (Project Hope). 2013;32(11):2013-2020.
• Ellison EC, Pawlik TM, Way DP, Satiani B, Williams TE. The impact of the aging population and incidence of cancer on future projections of general surgical workforce needs. Surgery. 2018;163(3):553-559.
• Chan EA, Jones A, Wong K. The relationships between communication, care and time are intertwined: a narrative inquiry exploring the impact of time on registered nurses' work. Journal of Advanced Nursing. 2013;69(9):2020-9.
• Mujagic E, Marti WR, Coslovsky M, Soysal SD, Mechera R, von Strauss M, et al. Associations of hospital length of stay with surgical site infections. World Journal of Surgery. 2018;42(12):3888-3896. doi: 10.1007/s00268-018-4733-4. [Epub ahead of print].
• Olson LK, Morse DJ, Duley C, Savell BK. Prospective, randomized in vivo comparison of a dual-active waterless antiseptic versus two alcohol-only waterless antiseptics for surgical hand antisepsis. American Journal of Infection Control. 2012;40(2):155-159.
• Ohno M, Shimada Y, Satoh M, Kojima Y, Sakamoto K, Hori S. Evaluation of economic burden of colonic surgical site infection at a Japanese hospital. The Journal of Hospital Infection. 2018;99(1):31-35.
• Badia JM, Casey AL, Petrosillo N, Hudson PM, Mitchell SA, Crosby C. Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. The Journal of Hospital Infection. 2017;96(1):1-15.
• Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Healthcare infection control practices advisory committee. Centers for disease control and prevention guideline for the prevention of surgical site infection. JAMA Surgery. 2017;152(8):784-791.
• De Jonge SW, Gans SL, Atema JJ, Solomkin JS, Dellinger PE, Boermeester MA. Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96(29):e6903.
• Vermeil T, Peters A, Kilpatick C, Pires D, Allegranzi B, Pittet D. Hand hygiene in hospitals: anatomy of a revolution. The Journal of Hospital Infection. 2018;1-10.
• Widmer AF. Surgical hand hygiene: scrub or rub?. The Journal of Hospital Infection. 2013;83(1):35-39.
• Misteli H, Weber WP, Reck S, Rosenthal R, Zwahlen M, Fueglistaler, P, et al. Surgical glove perforation and the risk of surgical site infection. Archives of Surgery. 2009;144(6):553-558.
• Kareem S, Mahmood AA, Hussein ZR. Alcohol based handrub versus traditional hand scrub as surgical hand disinfection in a tertiary eye teaching hospital in Iraq. Journal of Clinical & Experimental Ophthalmology. 2014;5(3):1-3.
• World Health Organization. WHO guidelines on hand hygiene in health care. Geneva. URL: http://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf;jsessionid=F86A2014830D3C3FA77D1152D9784136?sequence=1. 20.09.2018.
• Centers for Disease Control and Prevention. Healthcare providers. URL: https://www.cdc.gov/handhygiene/providers/index.html. 20.09.2018.
• Izaguirre A, Govela A, Delgado I, Mateos Troncoso C, Parra M, Álvarez Viaña E. Surgical hand antisepsis: experimental study. Annals of Surgical Treatment and Research. 2018;95(1):1–6.
• Gaspar GG, Menegueti MG, Lopes AER, Santos ROC, de Araújo TR, Nassiff A, et al. Alcohol-based surgical hand preparation: translating scientific evidence into clinical practice. Antimicrobial Resistance & Infection Control. 2018;7(80):1-7.
• Liu LQ, Mehigan S.The effects of surgical hand scrubbing protocols on skin integrity and surgical site infection rates: a systematic review. AORN Journal. 2016;103(5):468-482.
• Shen NJ, Pan SC, Sheng WH, Tien KL, Chen ML, Chang SC, et al. Comparative antimicrobial efficacy of alcohol-based hand rub and conventional surgical scrub in a medical center. Journal of Microbiology, Immunology, and Infection. 2015;48(3):322-328.
• Chen CF, Han CL, Kan CP, Chen SG, Hung PW. Effect of surgical site infections with waterless and traditional hand scrubbing protocols on bacterial growth. American Journal of Infection Control. 2012;40(4):15-17.
• Chamorey E, Marcy PY, Dandine M, Veyres P, Negrin N, Vandenbos F, et al. A prospective multicenter study evaluating skin tolerance to standard hand hygiene techniques. American Journal of Infection Control. 2011;39(1):6-13.
• Zandiyeh M, Roshanaei G. Effectiveness of three surgical alcohol-based hand rubs on skin flora. Iranian Journal of Nursing and Midwifery Research. 2015;20(2):221-225.
• Widmer AF. Replace hand washing with use of a waterless alcohol hand rub?. Clinical Infectious Diseases. 2000;31(1):136-143.
• Weight CJ, Lee MC, Palmer JS. Avagard hand antisepsis vs. traditional scrub in 3600 pediatric urologic procedures. Urology. 2010;76(1):5-7.
• Tsai JC, Lin YK, Huang YJ, Loh EW, Wen HY, Wang CH, et al. Antiseptic effect of conventional povidone-iodine scrub, chlorhexidine scrub, and waterless hand rub in a surgical room: A randomized controlled trial. Infection Control Hospital Epidemiology. 2017;38(4):417-422.
• Suchomel M, Gnant G, Weinlich M, Rotter M. Surgical hand disinfection using alcohol: the effects of alcohol type, mode and duration of application. The Journal of Hospital Infection. 2009;71(3):228-233.
• Abaza AF, Amine AE, Hazzah WA. Comparative study on efficacy of different alcohol hand rubs and routine hand wash in a health-care setting, Alexandria, Egypt. The Journal of the Egyptian Public Health Association. 2010;85(5-6):273-283.
• Padgette P. Understanding and improving surgical hand hygiene compliance. AORN Journal. 2017;105(6):614-618.
• Iwakiri K, Kobayashi A, Seki M, AndoY, Tsujio T, Hoshino M, et al. Waterless hand rub versus traditional hand scrub methods for preventing the surgical site infection in orthopedic surgery. Spine. 2017;42(22):1675-1679.
• Lai KW, Foo TL, Low W, Naidu G. Surgical hand antisepsis-a pilot study comparing povidone iodine hand scrub and alcohol-based chlorhexidine gluconate hand rub. Annals of the Academy of Medicine Singapore. 2012;41(1):12-16.
• Asadpoor-Dezaki Z, Barabady A, Abtahi D. Comparison of two surgical hand antiseptic techniques: Hand rubbing and hand washing with alcohol-based agent and 7.5% povidone iodine. Critical Care Nursing. 2016;9(4):e8255.
• Howard JD, Jowett C, Faoagali J, McKenzie B. New method for assessing hand disinfection shows that pre-operative alcohol/chlorhexidine rub is as effective as a traditional surgical scrub. The Journal of Hospital Infection. 2014;88(2):78-83.
• Pickering AJ, Boehm AB, Mwanjali M, Davis J. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania. The American Journal of Tropicam Medicine and Hygiene. 2010;82(2):270-278.
• Forer Y, Block C, Frenkel S. Preoperative hand decontamination in ophthalmic surgery: A comparison of the removal of bacteria from surgeons' hands by routine antimicrobial scrub versus an alcoholic hand rub. Current Eye Research. 2017;42(9):1333-1337.
• Ahmed-Lecheheb D, Cunat L, Hartemann P, Hautemanière A. Prospective observational study to assess hand skin condition after application of alcohol-based hand rub solutions. American Journal of Infection Control. 2012;40(2):160-164.
• Al-Biltagi M, Al-Ata J, Jiman-Fatani AA, Sindy A, Alghamdi A, Basabrain, A, et al. Comparative study of the efficacy of brushless surgical hand preparation techniques using antiseptic soap, alcohol and non-medicated soap. British Journal of Medicine and Medical Research. 2014;4(8):1663-1671.
• Sroka S, Gastmeier P, Meyer E. Impact of alcohol hand-rub use on meticillin-resistant Staphylococcus aureus: an analysis of the literature. The Journal of Hospital Infection. 2010;74(3):204-211.
• Nthumba PM, Stepita-Poenaru E, Poenaru D, Bird P, Allegranzi B, Pittet D, et al. Cluster-randomized, crossover trial of the efficacy of plain soap and water versus alcohol-based rub for surgical hand preparation in a rural hospital in Kenya. The British Journal of Surgery. 2010;97(11):1621-1628.
• Iwakiri K, Kobayashi A, Takaoka K, Ando Y, Hoshino M, Tsujio T, et al. Waterless rubbing versus traditional scrubbing for surgical site infection in orthopaedics. Orthopaedics Proceedings. 2018;98(2):68.
• Chen SH, Chou CY, Huang JC, Tang YF, Kuo YR, Chien LY. Antibacterial effects on dry-fast and traditional water-based surgical scrubbing methods: a two-time points experimental study. Nursing & Health Sciences. 2014;16(2):179-185.
• Gold NA, Avva U. Alcohol sanitizer. URL: https://www.ncbi.nlm.nih.gov/books/NBK513254/. 28.10.2018.
• George J, Alison KK, Higuera CA. Use of chlorhexidine preparations in total joint arthroplasty. Journal of Bone & Joint Infection. 2017;2(1):15-22.
• Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. The Bone &Joint Journal. 2013;95-B(11):1450-1452.
• Barbadoro P, Martini E, Savini S, Marigliano A, Ponzio E, Prospero E, et al. In vivo comparative efficacy of three surgical hand preparation agents in reducing bacterial count. The Journal of Hospital Infection. 2014;86(1):64-67.
• Suchomel M, Rotter M, Weinlich M, Kundi M. Glycerol significantly decreases the three hour efficacy of alcohol-based surgical hand rubs. The Journal of Hospital Infection. 2013;83(4):284-287.
• Macias JH, ArreguinV, Munoz JM, Alvarez JA, Mosqueda JL, Macias AE. Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect. American Journal of Infection Control. 2013;41(7):634-637. , Beausoleil CM, Paulson DS, Bogert A, Lewis GS. In vivo evaluation of the persistant and residual antimicrobial properties of three hand-scrub and hand-rub regimes in a simulated surgical environment. The Journal of Hospital Infection. 2012;81(4):283-287.
• Deshpande A, Fox J, Wong KK, Cadnum JL, Sankar T, Jencson A, et al. Comparative antimicrobial efficacy of two hand sanitizers in intensive care units common areas: A randomized, controlled trial. Infection Control & Hospital Epidemiology. 2018;39(3):267-271.
• Hayes GM, Reynolds D, Moens NM, Singh A, Oblak M, Gibson TW, et al. Investigation of incidence and risk factors for surgical glove perforation in small animal surgery. Veterinary Surgery. 2014;43(4):400-404.
• Hautemaniere A, Cunat L, Diguio N, Vernier N, Schall C, Daval MC, et al. Factors determining poor practice in alcoholic gel hand rub technique in hospital workers. Journal of Infection and Public Health. 2010;3(1):25-34.
• Anderson, PA, Savage JW, Vaccaro AR, Radcliff K, Arnold PM, Lawrence BD, et al. Prevention of surgical site infection in spine surgery. Neurosurgery. 2017;80(3S):114-123.
• Mahmoud MH, Asaad AM. Hand rubbing and scrubbing in relation to microbial count among surgical team members in a Saudi Hospital. The Egyptian Journal of Medical Sciences. 2012;33(1):503-517