An in-use microbiological comparison of two surgical hand disinfection techniques in cardiothoracic surgery: hand rubbing versus hand scrubbing C. Carro a, *, L. Camilleri a , O. Traore b , L. Badrikian b , B. Legault a , K. Azarnoush a ,C.Duale´ a , C. De Riberolles a a CHU Clermont-Ferrand, Cardiovascular Surgery Department, Gabriel Montpied University Hospital, Clermont Ferrand, France b CHU Clermont-Ferrand, Hygiene Department, Gabriel Montpied University Hospital, Clermont Ferrand, France Received 6 March 2007; accepted 27 June 2007 Available online 24 August 2007 KEYWORDS Surgical antisepsis; Alcohol solutions Summary Surgical site infection after heart surgery increases morbidity and mortality. The method of presurgical hand disinfection could influence the infection risk. From February to April 2003, we compared the micro- biological efficacy of hand-rubbing (R) and hand-scrubbing (S) procedures. The surgical team alternately used hand-scrubbing or hand-rubbing tech- niques every two weeks. Fingertip impressions were taken before and immediately after hand disinfection, every 2 h and at the end of the oper- ation. Acceptability of hand rubbing was assessed by a questionnaire. Mean durations of surgical procedures were 259  68 and 244  69 min for groups S and R respectively (P ¼ 0.43). Bacterial counts immediately after hand disinfection were comparable with the two techniques, but significantly lower in group R at the end of surgery. No differences were observed between the percentages of negative samples taken after 2 h, 4 h and at the end of surgery between the two groups. Bacterial skin flora reduction immediately after hand disinfection, after 2 h and 4 h of operating time and at the end of surgery was better in group R, but the difference was not statistically significant. Before surgery, the hand-rubbing method with alcohol solution preceded by hand washing with mild neutral soap is as ef- fective as hand scrubbing to reduce bacterial counts on hands. It decreased * Corresponding author. Address: Cardiovascular Surgery Department, CHU Gabriel Montpied, B.P. 69, 63003 Clermont-Ferrand Cedex 1, France. Tel.: þ33 4 7375 1576; fax: þ33 4 7375 1579. E-mail address: ccarro@chu-clermontferrand.fr 0195-6701/$ - see front matter ª 2007 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jhin.2007.06.016 Journal of Hospital Infection (2007) 67, 62e66 www.elsevierhealth.com/journals/jhin