Disinfection Efficacy of Hand Hygiene Based on Chlorhexidine Gluconate Content and Usage of Alcohol-based Hand-rubbing Solution

Recently, the procedure for surgical hand hygiene has been switching to a two-stage method and hand-rubbing method from the traditional hand-scrubbing method. Both the two-stage and hand-rubbing methods use alcohol-based hand-rubbing after hand washing. The former requires 5 min of antiseptic hand washing, and the latter 1 min of nonantiseptic hand washing. For a prolonged bactericidal effect in terms of surgical hand hygiene, chlorhexidine gluconate (CHG) has been noted due to its residual activity. However, no detailed study comparing the disinfection efficacy and prolonged effects according to different contents of CHG and the usage of alcohol-based hand-rubbing has been conducted. The glove juice method is able to evaluate disinfection efficacy and prolonged effects of the disinfectants more accurately because it can collect not only transitory bacteria but also normal inhabitants on hands. In the present study, we examined the disinfection efficacy and prolonged effects on alcohol-based hand-rubbing containing CHG by six hand-rubbing methods and three two-stage methods using the glove juice method. In both methods, 3 mL (one pump dispenser push volume) alcohol-based hand-rubbing solution containing 1% (w/v) CHG showed the highest disinfection efficacy and prolonged effects, and no significant difference was found between the hand-rubbing and two-stage methods. In the two methods of hand hygiene, the hand-rubbing method was able to save time and cost. Therefore, the data strongly suggest that the hand-rubbing method using a one pump dispenser push volume of alcohol-based hand-rubbing solution containing 1% (w/v) CHG is suitable for surgical hand hygiene.