Methods for Disinfection of Hands and Operation Sites.

In previous studies we compared the relative value of alternative methods for disinfecting the hands of nurses and surgeons and the skin of operation sites, but a number of relevant questions were not considered. For disinfection of the operation site alcoholic solutions of chlorhexidine (0.5%) and iodine (1%) were found to be equally effective and superior to a number of other agents (Lowbury, Lilly, and Bull, 1960), but we did not include laurolinium acetate, which was later reported by Verdon (1961) to be more effective than nine other antiseptic preparations, including 1 % iodine in alcohol; nor did we examine the removal of spore-bearing organisms. In studies on the disinfection of hands we confirmed the cumulative effect of repeated use of hexachlorophane detergent preparations, obtaining the best results with a liquid soap, and found some alternative methods which had comparable effects in reducing the hand flora and in preventing the emergence of bacteria through holes in rubber gloves (Lowbury and Lilly, 1960; Lowbury, Lilly, and Bull, 1963) ; we also assessed the value of ablution and disinfection in removal of transient flora (Lowbury, Lilly, and Bull, 1964). We did not examine the effects of varying the time of disinfection, of repeated treatments with antiseptics other than hexachlorophane, of varying the medium in which the antiseptic was mixed and the method by which it was applied. Experiments to fill some of these gaps are described below. In the light of these and previous experiments the choice of methods of skin disinfection suitable for various purposes in hospital and elsewhere are discussed.