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Abstract
Surgical hand preparation has been recommended since the nineteenth century as a measure
to reduce infection resulting from surgery. We review the evidence and major objectives
of surgical hand preparation, as well as the criteria for the choice of products currently
in use. Test and validation procedures for selecting products for surgical hand preparation
in North America and Europe are compared. Surgical hand antisepsis using medicated
soap and alcohol-based hand-rub formulations is discussed, including the technical
aspects, time required for the procedure, drying time, potential for side-effects,
and the parameters for the selection of the most appropriate formulations. Brushes
are not recommended for surgical hand preparation. Rapid antimicrobial action, wider
spectrum of activity, lower side-effects, and the absence of the risk of hand contamination
by the rinsing water, clearly favour the use of alcohol-based hand rubs for surgical
hand preparation, even in countries with limited resources where the provision of
water is scarce or of doubtful quality.