Comparing sterile bag rubbing and paint on technique in skin preparation of the hands

Abstract

Background: The aim of this study was to compare two techniques for surgical site skin preparation in hand surgery. Methods: We compared the standard sponge paint technique versus a plastic bag immersion technique using a 10% povidone-iodine with alcohol solution (Betadine, ORION Laboratories Pty Ltd, Balcatta, WA, Australia) to prepare surgical site skin for hand surgery. This sterile bag rubbing technique involves using a sterile plastic bag filled with 60mL of Betadine solution to immerse the subjects' hand. Samples were taken from 10 subjects for bacteria colony-forming unit (CFU) counts before and 3min after surgical site preparation in each group. Outcome measures were preparation time and CFU reduction with a plate impression test using commercially available agar slides. Results: The sterile bag rubbing technique significantly reduced (P < 0.0001) the time required for surgical site skin preparation (28s) compared with the standard technique (86s). Both techniques were found to have similar efficacy in the reduction of CFU. Conclusions: The sterile bag rubbing technique is a quicker alternative method for surgical site preparation in hand surgery and has comparable efficacy to the widely practised standard paint-on technique. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.