The mean reduction in phase 1 was 90.72% (LR = 3.23 right hand) and 89.97% (LR = 3.28 left hand) compared to 98.85% (LR = 3.29 right hand) and 98.92% (LR = 3.47 left hand) in phase 2. With regard to disinfection efficacy, the standardised protocol completely eliminated individual effects. Contrary, the reduction in bacterial numbers after disinfection by the standardised protocol was significantly higher (p<0.001) compared to routine every-day practice. Comparison of current habits and the standardised protocol revealed that the duration of hand washing had no significant effect on reducing bacteria. Individual habits differed distinctly with regard to time (up to 8 min) and amount of disinfectant (up to 48 ml) used both between participants and between various applications of a respective participant. Forty-six and 41 preparations were carried out during phase 1 and phase 2, respectively. The relative increase in bacterial numbers as a function of operation time (≤60 min, >60 min) and glove perforation as well as the interaction of both was investigated by using ANOVA. Differences in the reduction of relative bacterial numbers between current habits and the standardised protocol were investigated using Mann-Whitney-Test. Glove perforation test was carried out at the end of the surgical procedure. Bacterial colonies were manually counted. Hands were immersed in 100 ml sterile sampling fluid for 1 min and samples were inoculated onto Columbia sheep blood agar using the spread-plate method. Total bacterial counts were determined before and after hand washing, after disinfection, and after surgery. All participants (2 surgeons, 8 clinic members, 32 students) used Sterillium®. The standardised protocol defined hand washing for 1 min with liquid neutral soap without brushing and disinfection for 3 min. Assessment of individual habits focused on time for hand washing and disinfection, the amount of disinfectant used, and the usage of brushes. The major objectives of our study were to assess current habits for presurgical hand preparation (phase 1) among personnel in a veterinary hospital and their effectiveness in reducing bacteria from hands in comparison to a standardised protocol (phase 2). Nevertheless, basic knowledge seems to be low, even among specialised veterinary surgeons. Presurgical hand asepsis is part of the daily routine in veterinary medicine.

Surgical hand asepsis