Hand hygiene

Hand hygiene

Mastering asepsis is a fundamental pillar of surgical practice, especially in implantology where the infection risk is high. Hand washing and disinfection represent one of the first lines of defense against nosocomial infections and cross-contamination. Although this action appears simple, it requires absolute rigor and the application of precise protocols validated by health authorities.

1. Objectives of Hand Washing and Disinfection

There are two main objectives:

To reduce the transient flora (microorganisms acquired through contact) responsible for cross-contamination,

To decrease the resident flora (microorganisms naturally present on the skin) without completely eliminating it, as part of it is protective.

According to the Haute Autorité de Santé (HAS) and the WHO recommendations, hand hygiene is one of the most effective measures to prevent healthcare-associated infections (HAIs).

2. Types of Hand Washing According to Indication

In a surgical setting, three types of hand washing are distinguished based on the required level of asepsis:

a) Simple Hand Washing

When? Before and after any patient contact, after removing non-sterile gloves.

How? Water + mild soap, for 40 to 60 seconds.

Objective: Remove visible dirt and reduce transient flora.

b) Alcohol-Based Hand Rub (ABHR)

When? As a replacement for simple washing when hands are not visibly soiled.

How? Apply alcohol-based hand solution (ABHS), rub for 30 to 60 seconds until complete evaporation.

Objective: Rapid elimination of transient flora; proven effectiveness against enveloped viruses, bacteria, and fungi.

Note: ABHR does not replace surgical hand washing before an invasive procedure.

c) Surgical Hand Washing

When? Before any invasive surgery, including implant placement.

How? Water + antiseptic soap (e.g., 4% chlorhexidine or povidone-iodine), lasting 3 to 5 minutes according to protocol, focusing on forearms, interdigital spaces, and nails.

Complemented by: A surgical ABHR to reinforce the antiseptic effect.

3. Detailed Surgical Hand Washing Protocol

Remove jewelry, watches, and nail polish.

Open the sterile surgical brush pack (if used).

Wet hands and forearms thoroughly.

Apply surgical antiseptic (chlorhexidine soap or povidone-iodine).

Scrub methodically for 3 to 5 minutes:

Palm to palm,

Backs of hands,

Between fingers,

Thumbs,

Fingernails and nail edges (using sterile brush or sterile nail cleaner),

Forearms up to the elbows.

Rinse thoroughly from fingertips to elbows.

Dry with sterile compresses or disposable sterile towels.

Don sterile gloves without contaminating hands.

4. Additional Good Practices

Use ABHS products that comply with EN 1500 (hygiene) and EN 12791 (surgical) standards.

Do not use ABHS on wet or visibly soiled hands.

Always check the expiration dates of antiseptic products.

Regularly train staff on proper hand hygiene practices.

Strictly respect rubbing times, as they are critical for effectiveness.

Sur le sujet

Sterile Brush with Nail Cleaner

Blouse d'isolation stérile par 50

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Sterile adhesive protection tape

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