Efeito de diferentes métodos de antissepsia cirúrgica das mãos no controle microbiológico

Abstract

The antisepsis of the hands is one of the most important and critical moments within a surgical center, as it is one of the factors that can cause infections. The inadequate antisepsis technique, in addition to perforated gloves and cross-contamination between surgeon, patient and fomites, is often associated with contamination of the surgical field and postoperative complications. Due to all these reasons, the goal of this study was to evaluate the effectiveness of different methods of hand antisepsis, through the microbiological evaluation by quantitative method that analyzed regions of the hands where there is favoring of growth and maintenance of microorganisms. The study was carried out at the CCPA of the HV-UFU with 6 groups: 1- Surgical Brushing with Sponge and Rinse; 2- Surgical Brushing with No Rinse Sponge; 3- Surgical Brushing with Bristles and Rinse; 4- Surgical Brushing with Bristles with Rinse; 5- Friction Method with Rinse; 6 – Friction method with rinse, with 5 volunteers in each group, 3 samples were collected per person, 15 samples per group, totaling 90 samples in this experiment. For all methods and groups of antisepsis of the hands, the antiseptic of choice was Chlorhexidine Degerming 4%, standardizing 10 movements in each segment of the hands and forearms regardless of the antisepsis method used. After collecting samples using sterile swabs, the maintenance of the sample was done by using Letheen Broth transport buffer solution (LB) and the quantification by the serial dilution method and depth plating on a PCA agar. After incubation, the number of colony-forming units was compared on a percentage level of microbial reduction and statistically. All methods reduced significantly (p<0.05) the microbial load after antisepsis, maintaining the microbiological count after 1 hour of surgery (p>0.05). However, the methods of Surgical Brushing with Bristles and Rinse (3) and the Friction Method with Rinse (5) presented 99.0% microbial reduction, this being an excellent alternative. The analysis of the results showed that rinsing did represent a contributing factor in the control of microbial count. Thus, the study supports the possibility of excluding the brush for antisepsis, due to the abrasive effects caused by it, allied with the evidence that the friction method provides a significant effect on bacterial control.