Usefulness of an Alcohol Solution of N-Duopropenide for the Surgical Antisepsis of the Hands Compared with Handwashing with Iodine–Povidone and Chlorhexidine: Clinical Essay

Background. The usual surgical antisepsis involves scrubbing the skin with antiseptic solutions. This procedure can damage the skin, with the subsequent risk of infection for the patient. There are several efficient and quick-acting antiseptic alcohol solutions that require no scrubbing. Material and methods. We compare four alcohol solutions with the classic surgical handwashing products (chlorhexidine and iodine–povidone), in both in vitro (pigskin germ carriers) and in vivo studies. The latter (clinical essays) were done with healthy volunteers (crossed design) as well as with 154 surgical team members (Plastic Surgery or Traumatology), whose hand microbial flora were measured before and after scrubbing up and after surgery. Results and discussion. Because of its efficiency in the germ carrier, we chose a solution of N-duopropenide in 60° alcohol with emollients for further comparison with the standard surgical scrub: 4% chlorhexidine and 7.5% iodine–povidone. The quantitative, semiquantitative, and qualitative results obtained with N-duopropenide without scrubbing were better in the healthy volunteers and surgical teams. This product reduced hand microorganisms by more than 2 log, and maintained the reduction for the entire study period. Four percent chlorhexidine initially reduced colonization more than 2 log but lost part of its effect over time during the surgical intervention. Last, 7.5% iodine–povidone reduced the germs by 1 log but at the end of surgery there were even more germs than before washing. Conclusion. Because of its efficacy, persistent effect, and skin protection, we advise that scrubbing with classic antiseptic solutions be replaced with gentle washing with an alcohol solution such as N-duopropenide in alcohol.