The Hand Skin Assessment (HSA) consists of 4
scales and a total score (sum of the 4 scales). Each scale
was scored from 1 (negative) to 7 (positive). The total
score could range from 1 to 28. The primary outcome
measure was the change from baseline to week 3 in
HSA Total score, calculated by subtracting the period
baseline HSA score from the end of week 3 HSA score.
An increase in HSA score would indicate improved
skin condition. The effect of method of surgical hand
scrubs was assessed using a mixed model analysis of
variance. Fixed effects in the model were Sequence,
Method, Period and the random effect was Subject
nested within Sequence. The baseline HSA score was
included as a covariate. The least squares means were
estimated and the pair-wise comparisons were adjusted
using Tukey’s method. The pre-planned analysis
assumed no carryover effect was present at each
starting period. If carryover effects were seen, an
additional analysis was conducted on the raw scores
with no baselines included in the model and analyses
were also conducted separately for each period. There
were no significant differences in baseline HSA among
the 3 treatment groups. There were also no significant
differences in baseline HSA among the periods or
sequences. The change in HSA after 3 weeks is shown
in Table 8. Although hands were perceived as
improving slightly with Method C, there was not a
significant difference among the methods of surgical
hand scrubs (p=0.4819). The effects of Period and
Sequence were also not statistically significant. The
covariate of baseline HSA was statistically significant
(p