Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers

American Society for Microbiology Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers. Another reason not to refill bulk soap or antiseptic dispensers. Because of this is is particularly important to use single dose skin preparation solutions, as bulk dispensers post known problems.

“Didn’t Wash Hands” Alarm

Didn't Wash Hands alarm, Gary Larson — The Far Side

Our friends at the CDC created a helpful website about hand washing, which is worth the time to read through. I particularly appreciate their “Show me the science” section. ;) How to make your own “Didn’t Wash Hands” Alarm | MAKE. Big brother says, “wash your hands” More on Germ theory by How Stuff Works: Related: … Read more“Didn’t Wash Hands” Alarm

FDA Antiseptic sterility report

Sterility of Antiseptic Products:

FDA Investigates, Deliberates on Potential Recommendations

(Infection Control Today, PDF)
FDA investigates Antiseptics Sterility and potential recommendations_Page_01

In light of a number of high-profile recalls of contaminated alcohol prep products in the last several years, the Food and Drug Administration (FDA) is currently weighing whether or not to require sterility of patient skin prep products, specifically items such as alcohol prep pads used for injections, but it is not ruling out other surgical prep products.

On Dec. 12, 2012, the FDA held a hearing to receive expert testimony and public comment on how to address microbial contamination of these patient preoperative skin preparation drug products. It is a step in the ongoing investigational process that the agency is undertaking to determine issues related to sterility impacted by manufacturing processes.

An FDA spokesperson says that the panel members and FDA’s working group have received the submissions from the hearing and have been deliberating. FDA’s working group will be ready to make new recommendations in the coming months. The spokesperson adds that FDA’s working group has been soliciting clinician feedback from the FDA’s federal partners and other public health organizations, and that the agency will be ready to make new recommendations in the coming months.

Currently, patient preoperative skin preparations are not required to be sterile, since bacteria can contaminate these products at the time of manufacture or during product use. But because contaminated patient preoperative skin preparations have been associated with clinical infections and adverse outcomes, the FDA is exploring certain scientific and product-use issues related to patient preoperative skin preparations.

Patient preoperative skin preparations are over-the-counter (OTC) topical antiseptic drug products used to reduce the number of bacteria on the skin prior to medical procedures or injections. Although they are marketed predominantly to healthcare facilities, the use of these products extends beyond the healthcare facility setting.

Sacred cows in infection control

SSI Prevention: Evidence-Based Practices Replace Lingering “Sacred Cows’ in the OR
This report explores the prevention of surgical site infections (SSIs) within the context of evidence-based practices replacing “sacred cows” in the operating room. It focuses on the critical practice of preoperative hair removal.

When Thomas Paine noted in 1776 that, “A long habit of not thinking a thing wrong, gives it a superficial appearance of being right,” he could not have imagined that he was describing a current tug-of-war that still exists in some operating rooms today.

Skin antiseptics for piercing preparation

Thoughts on options for skin cleaning prior to body art procedures.

If a product is not labeled for surgical preparation, it really doesn’t matter how good of a hand and body soap or cleanser it is. It would only be a really strong hand wash product, or possibly aftercare for our purposes.

Choose a product that has claims as a “surgical skin preparation” because “scrub” alone is only the first step as cleaning. A two step “scrub then paint” process is appropriate and advised by CDC.  That involves a solvent or detergent scrub to clean followed by the surgical antiseptic to kill microbes to an irreducible minimum level of contamination.

What does the evidence suggest that we use?

I have replaced this two step product in my procedure with a sterile version by Aplicare or Cardinal Health
  • I’ve been using FDA approved skin prep PVP-I, CHG or alcoholic CHG, or alcohol depending on the area, with a preference for sterile products, and keep looking for other safe, appropriate options.
  • For oral preparation, an antiseptic mouthwash containing CPC or dilute H2O2 and friction.

I’m still looking for a universal surgical preparation agent, and have not found anything on the market that is both proven and FDA approved other than PVP-I, CHG based products and alcohol. I don’t want to recommend anything unless it is tested and labeled for the purpose.

Read moreSkin antiseptics for piercing preparation