Surgical hand preparation metode handscrub dan handrub berbasis antiseptik: A scoping review
DOI: https://doi.org/10.33024/hjk.v19i4.925
Antiseptik Handscrub Handrub Surgical Hand Preparation
Abstract
Background: Healthcare-associated infections (HAIs) are complications of healthcare that can increase morbidity, mortality, length of hospitalization, and additional costs, including surgical site infections (SSIs) caused by various factors such as microorganisms from the surgical environment. One important step in preventing SSIs is surgical hand preparation using antimicrobial soap or alcohol-based fluids which aims to reduce microorganisms, prevent infection, and increase the success of surgical procedures according to WHO and CDC guidelines.
Purpose: To determine the effectiveness of implementing surgical hand preparation using antiseptic-based hand washing and hand rubbing methods.
Method: Scoping review with article sources from PubMed, Scopus, and ScienceDirect published in the last 6 years in the period 2018-2024. The keywords used are "surgical team" or surgical staff or surgical procedures, "surgical hand preparation" or surgical cleaning or surgical rubbing, "bacteria" or microorganisms. Article assessment uses guidelines from The PRISMA Extension for Scooping Review (PRISMA-ScR).
Results: The most widely used type of antiseptic fluid in the operating room area is chlorhexidine gluconate with concentrations of 1%, 3%, and 5% for the handrub method, and a concentration of 4% for the handwash-scrub method. The amount of antiseptic needed for handrub is 6-10 ml and for handwash-scrub 20 ml; and the surgical handwash and surgical handrub methods are equally effective in reducing the number of germs on the hands.
Conclusion: Surgical handwash-scrub and surgical handrub are equally effective in reducing the number of bacteria on the hands, but surgical handrub with alcohol-based antiseptic and chlorhexidine is the main choice recommended by WHO and CDC because it is more practical, efficient, and effective than surgical handwash.
Keywords: Antiseptic; Handscrub; Handrub; Surgical Hand Preparation.
Pendahuluan: Health care–associated infections (HAIs) adalah komplikasi pelayanan kesehatan yang dapat meningkatkan morbiditas, mortalitas, durasi rawat inap, dan biaya tambahan, termasuk infeksi daerah operasi (IDO) yang disebabkan oleh berbagai faktor seperti mikroorganisme dari lingkungan operasi. Salah satu langkah penting dalam pencegahan IDO adalah persiapan tangan bedah menggunakan sabun antimikroba atau cairan berbasis alkohol yang bertujuan mengurangi mikroorganisme, mencegah infeksi, dan meningkatkan keberhasilan prosedur bedah sesuai pedoman WHO dan CDC.
Tujuan: Untuk meyelidiki tentang efektivitas dari pelaksanaan surgical hand preparation metode handscrub dan handrub berbasis antiseptik.
Metode: Scoping review dengan sumber artikel berasal dari pubMed, Scopus, dan ScienceDirect yang diterbitkan 6 tahun terakhir pada rentang 2018-2024. Kata kunci yang digunakan yaitu “surgical team” or surgical staff or surgical procedures, “surgical hand preparation” or surgical scrubbing or surgical rubbing, “bacteria” or microorganism. Penilaian artikel menggunakan panduan dari The PRISMA Extension for Scooping Review (PRISMA-ScR).
Hasil: Jenis cairan antiseptik area kamar operasi yang paling banyak digunakan adalah chlorhexidine gluconate konsentrasi 1%, 3%, dan 5% untuk metode handrub, konsentrasi 4% untuk metode handwash-scrub. Jumlah antiseptik yang diperlukan untuk handrub 6-10 ml dan untuk handwash-brush 20 ml; dan metode surgical handwash dan surgical handrub sama-sama efektif dalam menurunkan jumlah kuman ditangan.
Simpulan: Surgical handwash-scrub dan surgical handrub sama-sama efektif dalam menurunkan jumlah bakteri di tangan, tetapi surgical handrub dengan antiseptik berbasis alkohol dan chlorhexidine, menjadi pilihan utama yang direkomendasikan WHO dan CDC karena lebih praktis, efisien, dan efektif dibandingkan surgical handwash.
Kata Kunci: Antiseptik; Handscrub; Handrub; Surgical Hand Preparation.
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References
Akita, S., Fujioka, M., Akita, T., Tanaka, J., Masunaga, A., & Kawahara, T. (2022). Effects of hand hygiene using 4% chlorhexidine gluconate or natural soap during hand rubbing followed by alcohol-based 1% chlorhexidine gluconate sanitizer lotion in the operating room. Advances in Wound Care, 11(1), 1-9.
Akpokonyan, T. E., Esan, O., Ikem, I. C., Ako-Nai, K. A., & Omo-Omorodion, B. I. (2020). Hand bacterial repopulation dynamics following two methods of surgical hand preparation during elective orthopedic surgeries. Nigerian Medical Journal, 61(5), 241-244.
Asia Pacific Society of Infection Control. (2019). Pedoman APSIC Untuk Pencegahan Infeksi Daerah Operasi. Diakses dari: https://apsic-apac.org/wp-content/uploads/2019/02/APSIC%20SSI%20Prevention%20guideline%20Jan%202019%20IN.pdf
Brookes, Z. L., Bescos, R., Belfield, L. A., Ali, K., & Roberts, A. (2020). Current uses of chlorhexidine for management of oral disease: a narrative review. Journal of dentistry, 103, 103497.
Collins, A. S. (2011). Preventing health care–associated infections. Rockville: Agency for Healthcare Research and Quality.
de Bengoa Vallejo, R. B., Fernandez, D. S., Cervera, L. A., Aragón, L. M., Iglesias, M. E. L., Yurrita, L. R. C., & Lopez, D. L. (2018). Effectiveness of surgical hand antisepsis using chlorhexidine digluconate and parachlorometaxylenol hand scrub: Cross-over trial. Medicine, 97(42), e12831.
Durani, P., & Leaper, D. (2008). Povidone–iodine: use in hand disinfection, skin preparation and antiseptic irrigation. International Wound Journal, 5(3), 376-387.
Feng, W., Lin, S., Huang, D., Huang, J., Chen, L., Wu, W., & Wang, X. (2020). Surgical hand rubbing versus surgical hand scrubbing: Systematic review and meta-analysis of efficacy. Injury, 51(6), 1250-1257.
Gaspar, G. G., Menegueti, M. G., Lopes, A. E. R., Santos, R. O., de Araújo, T. R., Nassiff, A., & Bellissimo-Rodrigues, F. (2018). Alcohol-based surgical hand preparation: translating scientific evidence into clinical practice. Antimicrobial Resistance & Infection Control, 7, 1-7.
Gök, F., Kabu, F., & Özbayir, T. (2016). Surgical hand washing: A systematic review. Int J Antisep Disinfect Steril, 1(1), 23-32.
Hennig, T. J., Werner, S., Naujox, K., & Arndt, A. (2017). Chlorhexidine is not an essential component in alcohol-based surgical hand preparation: a comparative study of two handrubs based on a modified EN 12791 test protocol. Antimicrobial Resistance & Infection Control, 6, 1-6.
Herráiz Soria, E., Alou, L., Martin-Villa, C., Becerro-de-Bengoa-Vallejo, R., Losa-Iglesias, M., & Sevillano, D. (2024). Alcohol-Based Chlorhexidine and Potassium Sorbate Rub Strengthens the Effectiveness of Traditional Hand Scrubbing and Improves Long-Lasting Effectiveness—Evaluation of Hand Preparation Protocols According to EN 12791. Antibiotics, 13(5), 470.
Herruzo, R., Vizcaino, M. J., & Yela, R. (2018). Surgical hand preparation with chlorhexidine soap or povidone iodine: new methods to increase immediate and residual effectiveness, and provide a safe alternative to alcohol solutions. Journal of Hospital Infection, 98(4), 365-368.
Ho, Y. H., Wang, Y. C., Loh, E. W., & Tam, K. W. (2019). Antiseptic efficacies of waterless hand rub, chlorhexidine scrub, and povidone-iodine scrub in surgical settings: a meta-analysis of randomized controlled trials. Journal of Hospital Infection, 101(4), 370-379.
Hoang, T. P. N., Ghori, M. U., & Conway, B. R. (2021). Topical antiseptic formulations for skin and soft tissue infections. Pharmaceutics, 13(4), 558.
Lima, M. R. P., Filho, A. O. F., Bem, J. S. P., Simões, M. S. S., Santos, E. F., Arreguy, I. M. S., & Souza, F. B. (2019). Surgical hand preparation without rinsing: Influence of antiseptic agent on bacteriological contamination. J. Dent. Health Oral Disord. Ther., 10, 98-101.
Martin-Villa, C., Becerro-de-Bengoa-Vallejo, R., Alou, L., González, N., Losa-Iglesias, M., Gómez-Lus, M. L., & Sevillano, D. (2021). Comparing rubbing and scrubbing surgical hand antisepsis with propan-1-ol 60% in accordance with European regulation UNE-EN 12791: 2016+ A1: 2018. Infection Control & Hospital Epidemiology, 42(11), 1382-1384.
Mathur, P. (2011). Hand hygiene: back to the basics of infection control. Indian journal of medical research, 134(5), 611-620.
National Collaborating Centre for Women’s and Children’s Health. (2020). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. Diakses dari: www.nice.org.uk/guidance/ng125
Nthumba, P. M. (2020). Effective Hand Preparation for Surgical Procedures in Low-and Middle-Income Countries. Surgical Infections, 21(6), 495-500.
Santé, L., Gómez-Lus, M. L., Martin-Villa, C., Becerro-de-Bengoa-Vallejo, R., Alou, L., & Sevillano, D. (2023). Effect on the reduction of bacterial load after surgical hand antisepsis with triclosan 0.5% compared to triclosan 0.5% followed by 70% alcoholic solution. Infection Control & Hospital Epidemiology, 44(3), 517-519.
Tanner, J., Dumville, J. C., Norman, G., & Fortnam, M. (2016). Surgical hand antisepsis to reduce surgical site infection. Cochrane Database of Systematic Reviews, (1).
Wistrand, C., Söderquist, B., Falk-Brynhildsen, K., & Nilsson, U. (2018). Exploring bacterial growth and recolonization after preoperative hand disinfection and surgery between operating room nurses and non-health care workers: a pilot study. BMC infectious diseases, 18, 1-8.
World Health Organization. (2009). Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care. Diakses dari: https://www.who.int/publications/i/item/9789241597906
World Health Organization. (2016). WHO Surgical Site Infection Prevention Guidelines Web Appendix 10. Guidelines. Diakses dari: https://iris.who.int/bitstream/handle/10665/250680/9789241549882-eng.pdf
Yehouenou, C. L., Dohou, A. M., Fiogbe, A. D., Esse, M., Degbey, C., Simon, A., & Dalleur, O. (2020). Hand hygiene in surgery in Benin: opportunities and challenges. Antimicrobial Resistance & Infection Control, 9, 1-8.
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