Alcohol-based hand rubs are recommended and widely
used for surgical hand disinfection in many countries
[1,2]. The main aim of the pre-operative treatment of
hands is the reduction of resident skin bacteria to a minimum
in order to reduce the risk of surgical site infections
in case of perforated surgical gloves [3]. Alcohols are considered
to have better antimicrobial efficacy and dermal
tolerance which are two clear advantages in comparison
to antimicrobial soaps [4,5]. The application time for
alcohol-based surgical hand rubs has become shorter over
the last decades, and there was increasing evidence that
with well-formulated hand rubs an equivalent efficacy on
the resident hand flora can be achieved at an application
time of 1.5 min [6,7]. At the same time evidence was
cumulating to suggest that a 1 min hand wash which is
recommended and often performed before the disinfection
period may reduce the efficacy of the alcohol to some
extent [8]. But this effect has so far only been studied for
a 3 min application time of the hand rubs. The influence
of a preceding hand wash as well as of drying by evaporation
of the hand rub on the efficacy of disinfection with an
application time of 1.5 min is unknown. Therefore, these
influences were studied by determination of the efficacy
of a hand rub according to EN 12791 and compared with
the 3 min reference treatment [9]. The test design of EN
12791 ensures that the treated hands are sampled immediately
after the specific application time even if they are
still wet with the hand rub. In clinical practice, however, it
is recommended for healthcare workers to put on surgical
gloves only onto dry hands due to a better skin tolerance
and a lower risk for impairment of glove integrity [2,10].
Therefore, the test design of EN 12791 does not reflect the
clinical practice of surgical hand disinfection in that particular
point