Comparison of the In Vivo Efficacy of Alcohol-Based Pre-Surgical Handrubs: Chlorhexidine Gluconate Is Not Necessary to Meet FDA Efficacy Requirements

Pre-surgical hand disinfection by OR staff is critical to reducing bacterial load on hands and, thereby, the risk of microbial entry into the surgical wound during surgery. The FDA requires that products produce an immediate reduction of the skin microflora and to maintain microbial counts below baseline for six hours after use (persistence). A significant proportion of the products used in US hospitals are waterless alcohol-based pre-surgical handrubs. Products may be based on alcohol alone or contain chlorhexidine gluconate (CHG), which is believed to enhance persistent activity because it remains on skin after the alcohol has evaporated.