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Viljoen et al: Comparative antimicrobial efficacy of 4 surgical hand‐preparation procedures prior to application of an alcohol-based hand rub in veterinary students
Veterinary Surgery 3, 2022

🔍 Key Findings

  • Pre-ABHR hand preparation lowered CFUs at 120 minutes post-gloving compared to ABHR alone (P = .001)
  • pH-neutral soap followed by ABHR outperformed ABHR alone despite being nonmedicated (P = .001)
  • CHX and BAC prewashes showed better immediate CFU reduction post-preparation than pHN (P = .012)
  • No significant difference in total log10 CFU reduction across all four groups over the full surgical period (P = .362)
  • Glove perforation in the thumb was a significant contamination factor (P = .036)
  • All dogs recovered without surgical site infections, though SSI incidence was not a primary outcome
  • Neutralizer validation lacking, so CHX results interpreted cautiously
  • Study supports a 1-minute hand wash with pH-neutral soap prior to ABHR as effective and safe

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← Articles

Viljoen et al: Comparative antimicrobial efficacy of 4 surgical hand‐preparation procedures prior to application of an alcohol-based hand rub in veterinary students
Veterinary Surgery 3, 2022

🔍 Key Findings

  • Pre-ABHR hand preparation lowered CFUs at 120 minutes post-gloving compared to ABHR alone (P = .001)
  • pH-neutral soap followed by ABHR outperformed ABHR alone despite being nonmedicated (P = .001)
  • CHX and BAC prewashes showed better immediate CFU reduction post-preparation than pHN (P = .012)
  • No significant difference in total log10 CFU reduction across all four groups over the full surgical period (P = .362)
  • Glove perforation in the thumb was a significant contamination factor (P = .036)
  • All dogs recovered without surgical site infections, though SSI incidence was not a primary outcome
  • Neutralizer validation lacking, so CHX results interpreted cautiously
  • Study supports a 1-minute hand wash with pH-neutral soap prior to ABHR as effective and safe

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Multiple Choice Questions on this study

In Viljoen 2022 et al., on surgical hand prep protocols, what factor significantly influenced post-surgical contamination risk?

A. Age of the dog
B. Duration of surgery
C. Glove perforation in the thumb
D. Dominant hand used
E. Size of the dog

Answer: Glove perforation in the thumb

Explanation: Perforation of the thumb glove was a statistically significant factor contributing to higher CFU levels.
In Viljoen 2022 et al., on surgical hand prep protocols, which of the following statements is TRUE about CHX and BAC hand preparations?

A. They had no difference in CFU reduction compared to each other
B. CHX had higher CFUs than BAC post-wash
C. BAC was significantly better than CHX in long-term CFU suppression
D. CHX and BAC were inferior to pH-neutral soap
E. CHX had a higher skin reaction rate than BAC

Answer: They had no difference in CFU reduction compared to each other

Explanation: The study found no significant difference in CFU counts between CHX and BAC washes, although CHX showed lower counts than pHN.
In Viljoen 2022 et al., on surgical hand prep protocols, what was concluded about using pH-neutral soap prior to ABHR?

A. It was inferior to CHX in all time points
B. It caused more dermatitis than CHX
C. It was better than not washing prior to ABHR
D. It had no impact on CFUs
E. It is no longer recommended

Answer: It was better than not washing prior to ABHR

Explanation: pH-neutral soap followed by ABHR showed significantly better CFU reduction at 120 minutes compared to ABHR alone.
In Viljoen 2022 et al., on surgical hand prep protocols, why must the CHX results be interpreted cautiously?

A. Lack of statistical significance for CHX group
B. Contamination during sample collection
C. Participants were not blinded to treatment
D. Neutralizer validation was not performed
E. CHX concentration was too low

Answer: Neutralizer validation was not performed

Explanation: CHX results may be skewed due to unvalidated neutralizing agents, which can continue antibacterial action post-sample.
In Viljoen 2022 et al., on surgical hand prep protocols, which technique showed significantly lower CFUs at 120 minutes post-gloving compared to ABHR alone?

A. Hand prep with 4% CHX followed by ABHR
B. Hand prep with BAC followed by ABHR
C. Hand prep with pH-neutral soap followed by ABHR
D. Direct ABHR on rinsed hands
E. No preparation at all

Answer: Hand prep with pH-neutral soap followed by ABHR

Explanation: Groups A–C, which included hand washing before ABHR, had significantly fewer CFUs at 120 minutes than group D; pHN (Group C) was significantly better than ABHR alone.

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