Comparison of the effectiveness of painting onto the hand and immersing the hand in a bag, in pre-operative skin preparation of the hand

Abstract

The main goal of pre-operative skin preparation is to reduce the risk of postoperative wound infections by removing transient and commensal organisms from the skin. The aim of this study was to compare two methods of application of antiseptic solution in their effectiveness in removing these organisms from the skin. Fifty volunteers participated in the study. In 25 patients, the left hand was prepared using a standard paint technique and the right hand using the bag technique; in the other 25 the right was painted and the left was prepared using the bag technique. Three areas of the hand were examined: the paronychium of the thumb, the second web space and the hyponychium of the middle finger. Bacterial cultures were assessed after 5 days for growth. The bag technique proved better at removing organisms from the skin when comparing each site, and when comparing the total number of colony forming units (P = 0.002 for the thumb, P = 0.013 for the second web space and P = 0.003 for the middle finger). We concluded that pre-operative application of povidoneiodine to a hand using a non-sterile bag technique is more effective in removing skin organisms than the standard paint technique.