Surgical scrubbing: we can clean up our carbon footprints even better by disinfecting our hands.


Somner et al. provide an interesting evaluation on the impact of a leg-operated tap on the consumption of hot water in the surgical theatre. By changing from an elbow tap to a leg-operated tap, 5.7 L of hot water could be saved on average. For the UK it was calculated that w1400 t of carbon dioxide could be saved per year by this rather simple technological change. Nevertheless, the average consumption of hot water was still 5 L per operation. It is worth reflecting on whether consuming so much hot water for a preoperative treatment of hands is necessary at all. A surgical scrub using an antimicrobial soap and water is traditionally performed in many countries. Using a well-formulated alcohol-based hand rub instead of a surgical scrub for the preoperative treatment of hands, however, provides some advantages. A well-formulated alcohol-based hand rub has a strongerantimicrobial efficacy, it requires less time due to this increased efficacy, it can reduce skin irritation, and it is at least as effective in preventing surgical site infection. Even if a surgical hand disinfection is performed it has been recommended for decades to wash hands for 1 min or more before the alcohol-based hand rub is applied.Recentdata, however, indicate that the 1 min hand wash prior to the disinfection period may not be necessary at all and provides more disadvantages than advantages. It increases skin hydration significantly for up to 10 min and reduces the efficacy of the alcohol-based hand rub to some extent. If hands are not visibly soiled there isnogeneral need to routinelywashhandsprior to the disinfection period. That is why in most cases of a surgical hand disinfection the alcohol-based hand rub can be applied without a preceding 1 min hand wash. Following this evidence in surgical hand disinfection it may be required to review traditional behaviour in the surgical theatre, and this may also help save the remaining 5 L of hot water per operation which could save another 1400 t of carbon dioxide per year.

DOI: 10.1016/j.jhin.2008.09.021

Cite this paper

@article{Kampf2009SurgicalSW, title={Surgical scrubbing: we can clean up our carbon footprints even better by disinfecting our hands.}, author={Guenter Kampf}, journal={The Journal of hospital infection}, year={2009}, volume={71 1}, pages={91-2; author reply 92-3} }